Bernell P, Jacobsson B, Liliemark J, Hjalmar V, Arvidsson I, Hast R
Department of Medicine, Karolinska Institute at Danderyd Hospital, Stockholm, Sweden.
Br J Haematol. 1998 Jun;101(3):487-91. doi: 10.1046/j.1365-2141.1998.00733.x.
Gain of chromosome 7 represents one of the most frequent cytogenetic findings in B-cell lymphomas with a follicular growth pattern. We used fluorescence in situ hybridization (FISH) and a probe specifying chromosome 7 on lymph node imprints and/or bone marrow (BM) and peripheral blood (PB) smears from six consecutive patients with follicle centre lymphomas (FCLs) grade I or II (low-grade lymphomas), four patients with FCLs grade III and 11 patients with diffuse large B-cell lymphomas (DLBCLs) (high-grade lymphomas). We found gains of chromosome 7 in 14/18 successfully analysed cases (i.e. 2/6 FCLs grade I-II, 3/3 FLCs grade III and in 9/9 DLBCLs) using lymph node imprints. Moreover, the FISH technique demonstrated gains of chromosome 7 in 1/4 BM and 0/4 PB samples from FCLs grade I-II, in 2/4 BM and 2/4 PB specimens from FCLs grade III and in 4/9 BM and 2/9 PB samples from the DLBCLs. In contrast, morphologically recognizable lymphoma cells were seen in only 1/4 BM and 0/4 PB samples from the FCLs grade III and in 1/11 BM and 1/11 PB samples from the DLBCLs. We conclude that: (i) gain of chromosome 7 marks the progression from indolent to aggressive FCL and would appear to be a common finding in patients with FCLs grade III and in DLBCLs, (ii) clonal lymphoid cells occur frequently in BM and PB in high-grade lymphomas, making traditional staging by cytomorphology uncertain, and (iii) using gains of chromosome 7 as a marker of lymphoma cells, FISH is a useful method to detect minimal residual disease in FCLs grade III and DLBCLs.
7号染色体增多是具有滤泡生长模式的B细胞淋巴瘤中最常见的细胞遗传学发现之一。我们使用荧光原位杂交(FISH)技术和一个指定7号染色体的探针,对连续6例Ⅰ或Ⅱ级滤泡中心淋巴瘤(FCL,低度淋巴瘤)、4例Ⅲ级FCL患者以及11例弥漫性大B细胞淋巴瘤(DLBCL,高度淋巴瘤)患者的淋巴结印片和/或骨髓(BM)及外周血(PB)涂片进行检测。我们发现,使用淋巴结印片时,在18例成功分析的病例中有14例(即6例Ⅰ - Ⅱ级FCL中的2例、3例Ⅲ级FCL中的3例以及9例DLBCL中的9例)存在7号染色体增多。此外,FISH技术显示,在Ⅰ - Ⅱ级FCL的4份BM样本中有1份、4份PB样本中无;在Ⅲ级FCL的4份BM样本中有2份、4份PB样本中有2份;在DLBCL的9份BM样本中有4份、9份PB样本中有2份存在7号染色体增多。相比之下,仅在Ⅲ级FCL的4份BM样本中有1份、4份PB样本中无;在DLBCL的11份BM样本中有1份、11份PB样本中有1份能见到形态学上可识别的淋巴瘤细胞。我们得出以下结论:(i)7号染色体增多标志着惰性FCL向侵袭性FCL的进展,且似乎在Ⅲ级FCL患者和DLBCL患者中很常见;(ii)在高度淋巴瘤患者的BM和PB中,克隆性淋巴细胞频繁出现,使得传统的细胞形态学分期存在不确定性;(iii)以7号染色体增多作为淋巴瘤细胞的标志物,FISH是检测Ⅲ级FCL和DLBCL微小残留病的有用方法。