弥漫大B细胞性淋巴瘤分子亚型的蛋白表达研究

目的：在蛋白水平上研究国人弥漫性大B细胞淋巴瘤（diffuse large B-cell lymphoma,DLBCL）分子分型的蛋白表型特点,为DLBCL的病理诊断、预后和治疗提供依据。方法：取DLBCL标本52例行HE染色和免疫组化染色。在形态学分型的基础上,利用CD10、MUM1和bcl-6免疫标记对DLBCL进行分子分型,分为生发中心样B细胞样组（germi-nal center B-cell-like,GCB）和非生发中心样B细胞样组（non-germinal center B-cell-like,non-GCB）,分析其在DLBCL中的构成比,及CD10、MUM1和bcl-6的表达情况。结果：本组DLBCL中,non-GCB的构成比超过GCB（69.2%/30.8%）;统计学分析表明,GCB组间CD10、bcl-6、CD10/bcl-6的表达率的差异有显著性意义,其中CD10的表达率最高,bcl-6其次,CD10/bcl-6最低;non-GCB组间MUM1、MUM1/bcl-6的表达率的差异有显著性意义。结论：我国的DLBCL多起源于后生发中心B细胞,以non-GCB为主,预后较差。DLBCL在CD10、MUM1和bcl-6表达的差异对判定GCB组和non-GCB组有意义。

Investigation of Protein Expression in the Molecular Subtypes of Diffuse Large B-cell Lymphoma

Objective: To investigate protein expression in the molecular subtypes of diffuse large B-cell lymphoma (DLBCL), so as to provide discernible markers for the pathological diagnosis, treatment and prognosis of DLBCL. Methods: H&E and immunohistochemical staining were performed on samples from 52 cases with DLBCL. On the basis of immunohistochemical staining, the cases of DLBCL were further subtyped molecularly into the germinal center B-cell-like (GCB) and non-germinal center B-cell-like (non-GCB) groups, using CD10, MUM1 and bcl-6. Then the ratio of each subtype within DLBCL was analyzed in conjunction with the expression of CD10, MUM1 and bcl-6. Results: In this study, the number of non-GCB DLBCL cases was higher than the number of GCB DLBCL cases (69.2% versus 30.8%). Statistical analysis revealed a significant difference among the expression rates of CD10 alone, bcl-6 alone and CD10 and bcl-6 together in the GCB groups, in which the expression rate of CD10 ranked first, followed by bcl-6 and then CD10 and bcl-6 together. There was also a significant difference between the expression rates of MUM1 and MUM1 and bcl-6 together in the non-GCB groups. Conclusion: In China, most DLBCL cases originate from post-germinal center B-cells. The non-germinal center B-cell subtype is more prevalent and has a poorer prognosis. There was a significant difference in the expression of CD10, MUM1 and bcl-6 between the GCB and non-GCB groups that may be used for discrimination of the two subtypes.