Liang R, Chan W P, Kwong Y L, Xu W S, Srivastava G, Ho F C
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Cancer Genet Cytogenet. 1997 Sep;97(2):114-8. doi: 10.1016/s0165-4608(96)00388-3.
The incidence of BCL-6 gene rearrangement was studied in 39 Hong Kong Chinese patients with diffuse large B-cell lymphoma. The primary site of involvement was nodal in 18 cases and gastric in 21 cases. Clonal BCL-6 gene rearrangement was found in 17% of the patients with primary nodal and 48% with primary gastric lymphoma (p = 0.05). The clinical characteristics and treatment outcome of the 21 patients with primary gastric lymphoma were analyzed according to the BCL-6 status. Significantly more patients in the germline BCL-6 gene group had advanced stage (II, III and IV) of disease. Complete remission rate following primary therapy appeared to be higher for the positive rearrangement group (70% versus 36%), but it was not statistically significant. Those with a rearranged BCL-6 gene also appeared to have better survival at 5 years (58% versus 36%) but the difference was also not statistically significant. On the other hand, patients being classified as low risk according to the International Prognostic Index had significantly better survival at 5 years (89% versus 9%, p = 0.0001). We concluded that BCL-6 gene rearrangement was more commonly found in diffuse large B-cell lymphoma of primary gastric origin than its nodal counterpart and it may be playing a more important role in the pathogenesis of gastric large B-cell lymphoma. There was a trend that the BCL-6 gene rearrangement was associated with a more favorable outcome in patients with gastric large B-cell lymphoma but the difference was not statistically significant.
对39例香港中国弥漫性大B细胞淋巴瘤患者的BCL-6基因重排发生率进行了研究。受累的主要部位为淋巴结18例，胃21例。在原发性淋巴结淋巴瘤患者中，17%发现克隆性BCL-6基因重排，原发性胃淋巴瘤患者中这一比例为48%（p = 0.05）。根据BCL-6状态分析了21例原发性胃淋巴瘤患者的临床特征和治疗结果。胚系BCL-6基因组中疾病处于晚期（II、III和IV期）的患者明显更多。阳性重排组初始治疗后的完全缓解率似乎更高（70%对36%），但差异无统计学意义。BCL-6基因重排的患者5年生存率似乎也更高（58%对36%），但差异同样无统计学意义。另一方面，根据国际预后指数被归类为低风险的患者5年生存率明显更高（89%对9%，p = 0.0001）。我们得出结论，BCL-6基因重排在原发性胃弥漫性大B细胞淋巴瘤中比在淋巴结弥漫性大B细胞淋巴瘤中更常见，它可能在胃大B细胞淋巴瘤的发病机制中发挥更重要的作用。有趋势表明，BCL-6基因重排在胃大B细胞淋巴瘤患者中与更有利的预后相关，但差异无统计学意义。
