儿童成熟B-NHL中BCL-2、BCL-6蛋白表达及其临床病理意义

摘要

Objective The study was designed to investigate the protein expression of BCL-2 and BCL-6 in children with B-NHL and its clinic-pathological significance.Method Between July 1999 and October 2011,92 untreated patients (age 16 years or less)with newly diagnosed B-NHL (including BL, DLBCL and BL/DLBCL)were enrolled.We use the immunohistochemical technique (Envision TM)to detect BCL-2,BCL-6 protein expression levels.The expression of BCL-2 and BCL-6 and its association with clinic-pathological features and prognosis were analyzed.Results BCL-2 protein expression was performed in 47 B-NHL,the rate of positivity in BL and DLBCL were 9 .7% (3/3 1 ) and 33 .3%(5/15),respectively.There was significant difference between them (P=0.047).However,there was no association between the expression of BCL-2 and gender,stage and prognosis (P>0.05 ).BCL-6 protein expression was performed in 31 B-NHL,The 2-year EFS was 83.3% for children with BCL-6 protein expression,the other was 45.5%,there was significant difference between them (P=0.019). Children with positive BCL-6 protein expression had better prognosis.Conclusion BCL-2 protein expression was useful for distinguish BL from DLBCL and BCL-6 protein expression is a prognosis factor of B-NHL.%目的初步探讨儿童成熟B细胞非霍奇金淋巴瘤（B-NHL）中BCL-2、BCL-6蛋白表达及其临床病理意义。方法收集1999-2011年复旦大学附属儿科医院血液科收治的92例初治儿童B-NHL资料，包括伯基特淋巴瘤（burkitl lymphoma，BL）53例，弥漫大B细胞性淋巴瘤（DLBCL）38例，以及介于BL与DLBCL之间未能分类的B细胞淋巴瘤（BL/DLBCL）1例。92例患儿年龄≤16岁。所有病例均经过2家三级甲等医院病理科诊断。通过免疫组织化学技术检测儿童B-NHL中BCL-2、BCL-6蛋白表达情况。结果（1）92例儿童B-NHL中47例进行BCL-2蛋白检测，BCL-2表达阳性率在BL和DLBCL中分别为9.7％（3/31）和33.3％（5/15），差异具有统计学意义（P＝0.047）。BCL-2蛋白表达与性别、临床分期及预后无相关性（P＞0.05）。（2）31例儿童B-NHL进行BCL-6蛋白检测，BCL-6表达阳性组与阴性组2年EFS 分别为83.3％和45.5％，差异有统计学意义（P＝0.019）；在临床分期为Ⅲ-Ⅳ期儿童B-NHL中，BCL-6阳性组与阴性组的2年EFS分别为80％和40％，2组差异具有统计学意义（P＝0.023）。结论儿童B-NHL中BCL-2蛋白表达与病理类型有关，BL中BCL-2蛋白一般表达阴性，可用于BL 与 DLBCL 之间的鉴别；儿童 B-NHL 中BCL-6表达阳性的患儿预后较好，提示BCL-6可能是B-NHL的预后因素之一。