眼眶和全身弥漫大B细胞淋巴瘤的病理特点比较

背景眼眶弥漫大B细胞淋巴瘤（DLBCL）是眼眶发病率较高的中高度恶性淋巴瘤，由于病例较少，且无相应细胞系建立，系统研究较为困难。目的比较眼眶DLBCL与全身DLBCL临床病理标本的病理学特点和患者预后的异同，探讨将全身DLBCL细胞系用于眼眶DLBCL研究的可行性。方法收集2004-2009年天津市眼科医院及天津市肿瘤医院DLBCL患者的组织病理标本18例，其中眼眶来源3例，全身来源15例，对两组患者的预后情况进行跟踪随访，并绘制生存曲线。对患者的病理切片分别进行苏木精-伊红染色，并用免疫组织化学方法检测CD20、CD79α、CD45RO、CD10、BCL-6、mum-1、Ki-67、survivin的表达，比较眼眶DLBCL与全身DLBCL间上述检测结果的异同。结果眼眶DLBCL和全身DLBCL的病理检查结果均显示以中心母细胞型为主，符合DLBCL的诊断。眼眶DLBCL与全身DLBCL的组织标本CD20、CD79ct、CD45RO、Ki-67和survivin阳性表达率的差异均无统计学意义（P=0．167、0．442、1．000、1．000、0．442）。根据CD10、BCL-6、mum-1对眼眶DLBCL和全身DLBCL两组病例进行免疫分型，结果显示3例眼眶DLBCL均为非生发中心B-细胞样（GCB）型，其中2例标本BCL-6和mum-1均为阳性表达，CD10为阴性表达，另1例BCL．6、mum-1和CD10均为阴性表达；15例全身DLBCL中，GCB型者7例，CDIO表达均为阳性，6例标本BCL．6表达阴性；非GCB型8例，其中3例标本对CD10和BCL-6均呈阴性表达，5例标本对BCL．6和mum-1均呈阳性表达，而对CDIO呈阴性表达。眼眶DLBCL和全身DLBCL患者的生存曲线分析差异无统计学意义（P=0．067）。结论眼眶DLBCL与全身DLBCL的病理特点、特异标志物表达特点和预后结果均无明显差别，其流行病学特点和临床分期较接近，因此全身DLBCL细胞系可用于眼眶DLBCL的体外研究。

Comparison of pathological features and prognosis between orbital and systemic diffuse large B celllymphoma

Background Orbital diffuse large B cell lymphoma（DLBCL） is a kind of malignant lymphoma with higher morbidity,but the systematic study is difficult for the fewer eases and the lack of orbital DLBCL cell line. Objective This study was to compare the differences or similarities of histopathological characteristics between orbital DLBCL and systemic DLBCL,and to discuss whether systemic DLBCL cell line is available to in vitro research of orbit DLBCL. Methods The histopathological specimens were collected from 3 orbital DLBCL patients and 15 systemic DLBCL patients in Tianjin Eye Hospital and Tianjin Tumor Hospital from 2004 to 2009. The prognosis of the patients was followed-up, and the survival curve was drew. The histopathological examination of the specimens was performed using hematoxylin and eosin staining, and the expressions of CD20, CD79α, CD45RO, CD10, BCL-6, mum-1 ,Ki-67 and surviving in the specimens were detected by immunochemistry. The results mentioned above were analyzed and compared between orbital DLBCL and systemic DLBCL. Results The histopathological examination showed that the centroblastie type was the primary form in both orbital DLBCL and systemic DLBCL,according withthe diagnosis of DLBCL. The differences in the positive expression rate of CD20, CD79ct, CD45RO, Ki-67, survivin were not statistically significant between the two types of DLBCL （P = 0. 167,0. 442, 1. 000, 1. 000, 0. 442 ）. Immunochemistry revealed that 3 orbital DLBCL patients were germinal center B-cell-like （GCB） , and 2 of the patients showed the positive expression for BCL-6 and mum-1 as well as absent expression for CD10,but the other patient presented the absent expression for BCL-6, mum-1 and CD10. In 15 systemic DLBCL patients,7 were GCB type,with the positive expression for CD10 in all the 7 patients and absent expression for BCL-6 in 6 patients. In addition,in 8 of non-GCB type,3 appeared to be absent expressed for CD10 and BCL-6, and 5 were positive expressed for BCL-6 and mum-1 and absent expressed for