Primary breast diffuse large B-cell lymphoma shows a non-germinal center B-cell phenotype
Primary breast diffuse large B-cell lymphoma shows a non-germinal center B-cell phenotype
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DOI：
10.1038/modpathol.3800266
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发表时间：
2005-03-01
期刊：
影响因子：
7.5
通讯作者：
Abe, M
中科院分区：
文献类型：
--
作者：
Yoshida, S;Nakamura, N;Abe, M
相对于其他结外弥漫性大 B 细胞淋巴瘤，原发性乳腺弥漫性大 B 细胞淋巴瘤的预后较差。最近，使用组织微阵列将弥漫性大B细胞淋巴瘤细分为生发中心B细胞样和非生发中心B细胞类型。生发中心B细胞组的5年总体生存率优于非生发中心B细胞组。为了阐明原发性乳腺弥漫性大B细胞淋巴瘤临床效果不佳的原因，我们对15例原发性乳腺弥漫性大B细胞淋巴瘤（IE期；13例，IIE期；2例）患者进行了免疫组织化学检查，使用CD10、Bcl-6、MUM1和MIB-1等多种标记物以及免疫球蛋白重链基因可变区的分子分析。免疫组织化学显示CD10为0/ 15（阳性病例/检查病例），Bcl-6为5/ 15，MUM1为15/ 15，Bcl-2为10/ 15，CD5为2/ 15，CD40为4/ 15。原发性乳腺弥漫性大B细胞淋巴瘤中CD10(-)MUM1(+)的表达模式与非生发中心B细胞组相对应。此外，MIB-1指数分布在60%至95%之间，平均值为79%，表明淋巴瘤细胞高度增殖。原发性乳腺弥漫性大B细胞淋巴瘤的免疫球蛋白重链基因可变区的突变频率为1-10%（7例），并且正在进行的突变分析中存在0-1个额外突变（5例）。原发性乳腺弥漫性大 B 细胞淋巴瘤具有非生发中心 B 细胞群的特征。总之，原发性乳腺弥漫性大 B 细胞淋巴瘤具有非生发中心 B 细胞表型并具有高 MIB-1 指数。因此，这些特征可能与不良预后相关。
Primary breast diffuse large B- cell lymphoma has a poor prognosis relative to other extranodal diffuse large B-cell lymphoma. Recently, diffuse large B- cell lymphoma has been subclassified as germinal center B- cell- like and nongerminal center B- cell types using tissue microarrays. The 5- year overall survival rate of the germinal center B- cell group is better than that of the nongerminal center B- cell group. To elucidate the reason for which primary breast diffuse large B- cell lymphoma has a poor clinical outcome, we investigated 15 patients with primary breast diffuse large B- cell lymphoma ( stage IE; 13 cases, stage IIE; two cases) by immunohistochemistry using various markers including CD10, Bcl- 6, MUM1 and MIB- 1 and by molecular analysis of the immunoglobulin heavy chain gene variable region. Immunohistochemistry showed 0/ 15 ( positive cases/ examined cases) for CD10, 5/ 15 for Bcl- 6, 15/ 15 for MUM1, 10/ 15 for Bcl- 2, 2/ 15 for CD5 and 4/ 15 for CD40. The expression pattern of CD10( -) MUM1( +) in primary breast diffuse large B- cell lymphoma corresponded to the nongerminal center B- cell group. Moreover, the MIB- 1 index was distributed from 60 to 95% with a mean of 79%, indicating a high proliferation of the lymphoma cells. The immunoglobulin heavy chain gene variable region of primary breast diffuse large B- cell lymphoma had a mutation frequency of 1 - 10% ( seven cases) and 0 - 1 additional mutations in ongoing mutation analysis ( five cases). Primary breast diffuse large B- cell lymphoma had characteristics of the nongerminal center B- cell group. In conclusion, primary breast diffuse large B- cell lymphoma has a nongerminal center B- cell phenotype and has a high MIB- 1 index. These features might therefore be associated with poor prognosis.