Clinicopathologic impact of genetic aberrations in gastrointestinal lymphoma

背景：60-90%的淋巴结滤泡性淋巴瘤（FL）存在染色体易位t（14;18）（q32;q21）/IGH-BCL 2。方法与结果：48例胃肠道FL患者的临床病理和分子特征进行了研究。受累部位为十二指肠（54%），空肠（52%），回肠（52%），胃（29%）和结直肠（15%）。间期荧光原位杂交检测t（14;18）39例（81%）。在t（14;18）阳性组中，多部位受累（69% vs. 0%）、淋巴瘤性息肉病型表现（72% vs. 22%）和组织学分级1或2级（92% vs. 56%）比阴性组更常见。此外，t（14;18）阳性组的完全缓解率低于阴性组（56% vs. 100%，P=0.018），前者的无事件生存率有下降趋势（P=0.089）。结论：t（14;18）/IGH-BCL 2在胃肠道滤泡性淋巴瘤中较常见。这种易位可能是不良临床过程的预测因子。

Background : Chromosomal translocation t(14;18)(q32;q21)/IGH-BCL2 is found in 60-90% of nodal follicular lymphomas (FL). The prevalence and clinical significance of the translocation have not been examined in gastrointestinal FL. Methods & Results : Clinicopathologic and molecular features were investigated in 48 patients with gastrointestinal FL. The site of involvement was the duodenum (54%), the jejunum (52%), the ileum (52%), the stomach (29%), and the colorectum (15%). t(14;18) was detected in 39 (81%) cases by the interphase fluorescence in situ hybridization. The involvement of multiple sites (69% vs. 0%), a manifestation of lymphomatous polyposis type (72% vs. 22%) and a histological grade of 1 or 2 (92% vs. 56%) were more frequent in the t(14;18)-positive group than in the negative group. In addition, the rate of complete remission was lower in the t(14;18)-positive group than in the negative group (56% vs. 100%, P=0.018) with a trend towards poorer event-free survival in the former group (P=0.089). Conclusions : t(14;18)/IGH-BCL2 occurs frequently in gastrointestinal follicular lymphomas. This translocation may be a predictor for the adverse clinical course.