睾丸弥漫大B细胞淋巴瘤中MyD88及CD79B基因突变及意义

摘要

目的 探讨睾丸原发性弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中MyD88及CD79B基因突变及意义.方法 回顾性分析15例睾丸原发性DLBCL的临床病理学特点,采用免疫组化及Sanger测序法检测原发性DLBCL中MyD88及CD79B基因突变,分析MyD88及CD79B基因突变与肿瘤临床病理学特点、NF-KB蛋白在细胞核表达之间的关系.结果 免疫组化显示15例DLBCL均为非生发中心B(non germinal center B,non-GCB)细胞型,4例存在CD79B基因Y196位点突变(26.7％),7例存在MyD88基因L265位点突变(46.7％),3例同时存在CD79B及MyD88基因突变(20％).8例患者获得随访,未发现CD79B及MyD88基因突变与预后的相关性.结论 中国人睾丸原发性DLBCL中存在较高的CD79B基因Y196位点和(或)MyD88基因L265位点突变,为针对这些突变基因的分子靶向治疗提供依据.%Purpose To explore the mutation of CD79B and MyD88 in primary testicular diffuse large B cell lymphoma and their significance.Methods Histopathologic features were observed in 15 cases of primary testicular diffuse large B cell lymphoma and immunophenotype was analyzed by immunohistochemical staining (IHC).Sanger sequencing was used to detect CD79B Y196 and MyD88 L265 mutation in these cases.The relationship between CD79B,MyD88 mutation and the clinicopathological features was analyzed.Results Immunophenotypically,15 cases were non germinal center B cell type.CD79B (Y196) mutation was detected in 4 cases (26.7％).For MyD88,L265 mutation was found in 7 cases (46.7％).CD79B and MyD88 mutations were found in 3 cases.The followup information was obtained in 8 patients.No association was found between CD79B,MyD88 mutation and outcome of patients.Conclusion Primary testicular diffuse large B cell lymphoma of non germinal center B cell type is a rare aggressive B cell lymphoma with poor prognosis and poor response to chemotherapy.CD79B,MyD88 gene mnutation was detected in Chinese patients with frequency of 26.7％ and 46.7％ respectively.It is possible for molecular targeted therapy of the primary testicular diffuse large B cell lymphoma on the basis of high frequency of CD79B and MyD88 gene mutation.