CD21及CD43对黏膜相关边缘区B细胞淋巴瘤和良性淋巴组织增生的鉴别诊断价值

摘要

目的 探讨CD21、CD43蛋白表达对黏膜相关边缘区B细胞淋巴瘤(MALToma)和良性淋巴组织增生的鉴别诊断价值.方法 应用免疫组织化学法检测25例良性淋巴组织增生(对照组)及25例MALToma(病例组)组织CD21、CD43蛋白表达情况.结果 病例组100%(25/25)显示出CD21+的异常滤泡树突细胞网,多数稀疏破碎,少数扩大增生或融合成片;对照组100%(25/25)显示出CD21+的完整滤泡树突细胞网,未显示异常滤泡树突细胞网.两组异常滤泡树突细胞网阳性率比较,差异有统计学意义(χ2=46.080,P=0.000).病例组CD20+细胞中CD43+表达率为24%(6/25),对照组CD20+细胞中CD43均阴性,两组差异有统计学意义(χ2=4.375,P=0.030).结论 CD21+异常滤泡树突细胞网以及CD20+细胞中CD43+表达对MALToma和良性淋巴组织增生有鉴别诊断意义.在少数情况下,MALToma组织中异常的滤泡树突细胞网扩大增生或融合成片.%Objective To investigate the values of CD21 and CD43 proteins in the differential diagnosis of mucosa-associated marginal zone B-cell lymphoma (MALToma) from benign lymphadenosis. Methods The expression of CD21 and CD43 proteins in the tissues of 25 MALToma (case group) and 25 benign lymphadenosis (control group) was detected by immunohistochemistry. Results Abnormal CD21+follicular dendritic cells (FDC) meshes were found in all patients of case group. Most of the FDC meshes were sparse and broken, and a few were enlarged or fused into pieces. Intact CD21+FDC meshes were all found, and abnormal FDC meshes were not found in control group. The positive rate of abnormal FDC meshes in case group was significantly increased compared with that in control group (χ2 = 46.080, P= 0.000). The expression rate of CD43+in CD20+cells was 24 % (6/25) in case group, but it was negative in control group (χ2=4.375, P=0.030). Conclusions Abnormal CD21+FDC meshes and CD43+expression in CD20+cells are useful in the differential diagnosis between MALToma and benign lymphadenosis. The abnormal FDC meshes of MALToma are enlarged or fused in the minority of cases.