The t(14;18) is associated with germinal center-derived diffuse large B-cell lymphoma and is a strong predictor of outcome.
The t(14;18) is associated with germinal center-derived diffuse large B-cell lymphoma and is a strong predictor of outcome.
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发表时间：
2003-06
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通讯作者：
S. Barrans;P. Evans;S. O'Connor;S. Kendall;R. Owen;A. Haynes;G. Morgan;A. Jack
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作者：
S. Barrans;P. Evans;S. O'Connor;S. Kendall;R. Owen;A. Haynes;G. Morgan;A. Jack
t（14; 18）存在于弥漫性大B细胞淋巴瘤（DLBCL）的显著比例中，然而，易位的预后作用以及与转化的滤泡性淋巴瘤的关系仍然存在争议。为了澄清这些不确定性，间期荧光原位杂交（FISH）被用来确定t（14;18）在淋巴结DLBCL中的发生率，这与BCL 2表达、生发中心（GC）免疫表型和患者预后相关。对来自137个原发结DLBCL的石蜡提取的细胞核进行FISH。137例新发DLBCL中有18例为t（14;18）阳性。t（14; 18）最常与表达GC表型的DLBCL亚群相关，定义为CD 10+，BCL 6+（GC型DLBCL）：47例中有14例（30%）阳性，而非GC组89例中有4例（5%）阳性（Pearson χ 2 = 28.4; P < 0.0001）。所有易位病例均表达BCL 2蛋白，然而，40例表达BCL 2蛋白而无t（14;18）。与无易位的GC型DLBCL患者相比，具有t（14;18）的GC型DLBCL患者的生存率显著更差（2年生存率分别为29%和63%; P = 0.006）。在没有易位的病例中，BCL 2蛋白表达不影响生存。相反，在DLBCL的非GC组中，BCL 2蛋白表达将2年总生存率从BCL 2阴性组的64%降低至38%，中位生存期为15.0个月（P = 0.02）。总之，t（14;18）在DLBCL中很常见，特别是在GC型DLBCL中，其中易位的存在具有不良预后影响。BCL 2蛋白表达定义了一组预后不良的非GC DLBCL患者。
The t(14;18) is present in a significant proportion of diffuse large B-cell lymphomas (DLBCLs), however, the prognostic effect of the translocation and the relationship with transformed follicular lymphoma remains controversial. To clarify these uncertainties, interphase fluorescence in situ hybridization (FISH) was used to determine the incidence of the t(14;18) in nodal DLBCL, and this was correlated with BCL2 expression, germinal center (GC) immunophenotype, and patient outcome. FISH was performed on paraffin-extracted nuclei from 137 de novo nodal DLBCLs. Eighteen of 137 de novo DLBCLs were t(14;18) positive. The t(14;18) was most commonly associated with the subset of DLBCLs that expressed a GC phenotype, defined as CD10+, BCL6+ (GC-type DLBCL): positive in 14 of 47 (30%) cases, compared with 4 of 89 (5%) in the non-GC group (Pearson's chi(2) = 28.4; P < 0.0001). All cases with a translocation expressed BCL2 protein, however, 40 expressed BCL2 protein without a t(14;18). GC-type DLBCL patients with a t(14;18) had a significantly worse survival compared with GC-type DLBCL patients without the translocation (2-year survivals were 29 and 63%, respectively; P = 0.006). Of the cases without the translocation, BCL2 protein expression did not affect survival. In contrast, in the non-GC group of DLBCLs, BCL2 protein expression reduced the 2-year overall survival from 64% in the BCL2-negative group to 38%, with a median survival of 15.0 months (P = 0.02). In conclusion, the t(14;18) is common in DLBCLs, particularly in GC-type DLBCLs, where the presence of the translocation has a poor prognostic effect. BCL2 protein expression defines a group of non-GC DLBCL patients with a poor prognosis.