Clinicopathological, immunologic and genetical analyses of diffuse large cell lymphoma

弥漫性大细胞淋巴瘤的临床病理学、免疫学和遗传学分析

• 批准号: 10670182
• 负责人: SUZUMIYA Junji
• 金额: $ 1.73万
• 依托单位: Fukuoka University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1998
• 资助国家: 日本
• 起止时间: 1998 至 2000
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10670182/
• 关键词: lymphoma; large cell lymphoma; bcl-1; bcl-2; bcl-6; EBV; intravascular; spleen; リンパ腫; 大細胞リンパ腫; 免疫学的検討; 遺伝子学的検討; PCR法; 大細胞型リンパ腫

(1)We reviewed 572 patients with nodal T-cell lymphomas and 98(17.1%) patients were found to have diffuse large cell lymphoma. Among these patients, there were 73 patients with HTLV-I-negative T-cell lymphoma, which appeared to have a different prognosis from those of adult-T cell leukemia/lymphoma. We analyzed 708 patients with B-cell lymphoma and showed 417(58.8%) patients with diffuse large B-cell lymphoma (DBLB). Among them, 318(44.9%) patients had common type and 99(14.0%) had variant type. An overall 5-year survival was 47% in DLBL.The prognosis was worse in variant type than that of common type. The significantly different outcomes were noticed depending on stage and age. (2) The immunohistochemical examination in 158 patients of DLBL that a high p53 expression and low bcl-6 expression were associated with a shorter disease free survival time. The histologic variant type such as bcl-1+CD5+DLBL.EMA+CD30-DLBL, and high bcl-2 expression and low Ki-67 proliferation activity had a te … More ndency of worse survival with no statistical significance. By the multivariate analysis, significant factors were in order of the old age, poor International Prognostic Index and high p53 expression. The expression of p21/WAF1, mdr and c-myc did not influence the surviva1. Among 137 de novo DLBL patients, the Southern blotting analysis showed that structural alterations of bcl-1, bcl-2, bcl-6, and c-myc were detected in 15.3%, 5.8%, 16.1%, and 10.2%, respectively. Patients with rearranged bcl-6 and c-myc tended to have a poorer survival. (3) We reported cases of intravascular lymphoma (IVL), a variant of DLBL, which expressed CD5 significantly and determined that IVL was originated from the post-germinal center cells using the direct sequence analysis of immunoglobulin heavy chain gene. (4) DLBL is the commonest in the extranodal lymphomas and occurs in various organs, such as spleen, lung, GI-tracts, and nasal cavity. Patients with primary splenic DLBL had a good prognosis, while those with primary pulmonary DLBL had a poor prognosis. In 33 patients of primary nasal lymphoma, there were 5 patients with DLBL.It was of interest that 2 patients had monoclonal EBV infection. Less

(1)我们回顾了572例淋巴结t细胞淋巴瘤患者，其中98例（17.1%）发现弥漫性大细胞淋巴瘤。其中htlv - i阴性t细胞淋巴瘤73例，其预后与成人t细胞白血病/淋巴瘤不同。我们分析了708例b细胞淋巴瘤，其中417例（58.8%）为弥漫性大b细胞淋巴瘤（DBLB）。其中普通型318例（44.9%），变异型99例（14.0%）。DLBL患者的5年总生存率为47%。变异型预后较普通型差。根据不同的阶段和年龄，观察到显著不同的结果。(2) 158例DLBL患者的免疫组化检查发现p53高表达、bcl-6低表达与较短的无病生存期相关。组织学变异类型如bcl-1+CD5+DLBL。EMA+CD30-DLBL、bcl-2高表达、Ki-67增殖活性低的患者生存率较低，但差异无统计学意义。通过多因素分析，显著性因素依次为年龄大、国际预后指数差、p53高表达。p21/WAF1、mdr和c-myc的表达不影响存活。在137例新发DLBL患者中，Southern blotting分析显示，bcl-1、bcl-2、bcl-6和c-myc的结构改变分别为15.3%、5.8%、16.1%和10.2%。重排bcl-6和c-myc的患者往往生存率较低。(3)我们报道了一种DLBL变异的血管内淋巴瘤（IVL）病例，该病例显著表达CD5，并利用免疫球蛋白重链基因的直接序列分析确定IVL起源于生发后中心细胞。(4) DLBL是结外淋巴瘤中最常见的，可发生于脾、肺、gi束、鼻腔等多个器官。原发性脾型DLBL预后较好，而原发性肺型DLBL预后较差。33例原发性鼻淋巴瘤中，有5例伴有DLBL。值得注意的是，2例患者有单克隆EBV感染。少

项目成果

Ohshima,K.,Suzumiya,J., et al.: "Nodal T-cell lymphoma in an HTLV-I-endemic area : proviral HTLV-I DNA, histological classification and clinical evaluation."Brit.J.Haematol.. 101. 703-711 (1998)

Ohshima,K.、Suzumiya,J. 等人：“HTLV-I 流行区的结节 T 细胞淋巴瘤：前病毒 HTLV-I DNA、组织学分类和临床评估。”Brit.J.Haematol.. 101

Suzumiya,J.,Ohshima,K., et al.: "Nasal lymphomas in Japan : A high prevalence of Epstein-Barr virus type A and deletion within the latent membrane protein gene."Leukemia and Lymphoma. 35. 567-578 (1999)

Suzumiya,J.、Ohshima,K. 等人：“日本的鼻淋巴瘤：A 型 Epstein-Barr 病毒的高患病率和潜伏膜蛋白基因内的缺失。”白血病和淋巴瘤。

Suzumiya,J.,Ohshima,K., et al.: "Epstein-Barr virus (EBV)-induced B-cell proliferative disorder after chemotherapy in a patient with hemophagocytic lymphohistiocytosis with associated EBV-induced T-cell proliferation."Leukemia and Lymphoma. 37. 593-604 (2

Suzumiya, J.、Ohshima, K. 等人：“噬血细胞性淋巴组织细胞增多症患者化疗后，EB 病毒 (EBV) 诱导的 B 细胞增殖性疾病，并伴有 EBV 诱导的 T 细胞增殖。”白血病和

Fujimura,S., Suzumiya,J. et al.: "Retinoacid induce growth inhibition and apoptosis in adult T-cell leukemia (ATL) cell lines." Leukemia Res.22. 611-618 (1998)

藤村，S.，凉宫，J.

Kawasaki,C., et al.: "Rearrangement of bcl-1, bcl-2, bcl-6, and c-myc in diffuse large B-cell lymphomas."Leukemia and Lymphoma. (in press).

Kawasaki,C., et al.：“弥漫性大 B 细胞淋巴瘤中 bcl-1、bcl-2、bcl-6 和 c-myc 的重排。”白血病和淋巴瘤。