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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。
Objective To investigate the expression of BCL-2 and BCL-6 proteins and their clinicopathological significance in children with B-cell non-Hodgkin’s lymphoma (B-NHL). Methods The B-NHL data of 92 newly diagnosed children admitted to Department of Hematology, Fudan University affiliated pediatric hospital from 1999 to 2011 were collected, including 53 cases of burkitl lymphoma (BL), diffuse large B-cell lymphoma (DLBCL) 38 cases, and 1 case of unclassified B-cell lymphoma (BL / DLBCL) between BL and DLBCL. 92 cases of children ≤ 16 years of age. All cases were diagnosed by pathology department of two third-class first-class hospitals. The expression of BCL-2 and BCL-6 protein in children with B-NHL was detected by immunohistochemistry. Results (1) BCL-2 protein was detected in 47 of 92 children with B-NHL. The positive rates of BCL-2 in BL and DLBCL were 9.7% (3/31) and 33.3% (5/15) Statistically significant (P = 0.047). BCL-2 protein expression had no correlation with sex, clinical stage and prognosis (P> 0.05). (2) BCL-6 protein was detected by B-NHL in 31 children. The 2-year EFS of BCL-6 positive group and negative group were 83.3% and 45.5% respectively, with significant difference (P = 0.019) In children with stage III-IV B-NHL, the 2-year EFS of BCL-6 positive and negative groups were 80% and 40%, respectively, with significant difference between the two groups (P = 0.023). Conclusions The expression of BCL-2 protein in B-NHL is related to the pathological type. The expression of BCL-2 protein in BL is negative and can be used for the identification of BL and DLBCL. The prognosis of children with BCL-6 positive expression in B-NHL Better, suggesting that BCL-6 may be one of the prognostic factors of B-NHL.