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目的了解非霍奇金淋巴瘤(NHL)患者染色体异常与 WHO 病理组织分型之间的关系,并与国外 NHL 染色体异常类型进行比较。方法采用常规染色体 G 带分析和荧光原位杂交(FISH)方法对155例 NHL 患者的淋巴结组织进行细胞和分子遗传学研究。结果 155例 NHL 患者中常见的病理类型是弥漫大 B 细胞淋巴瘤(DLBCL)(59例,38.1%)、滤泡性淋巴瘤(27例,17.4%)、B 小淋巴细胞淋巴瘤(16例,10.3%)、非特指周围 T 细胞淋巴瘤(13例.8.4%)、血管免疫母细胞性 T细胞淋巴瘤(11例,7.1%)。155例 NHL 患者中染色体异常为119例,占76.8%。滤泡性淋巴瘤、B 小淋巴细胞淋巴瘤、DLBCL、间变性大细胞淋巴瘤和前体 T 淋巴母细胞淋巴瘤染色体异常率较高,分别为96.3%、87.5%、86.4%、83.3%、83.3%。DLBCL 中复杂核型占86.3%,染色体结构异常累及最多的是3,6,14,1号染色体,41.2%为3q27异常,43.1%的病例有1号染色体异常。6q21、6q23和6q25异常占23.5%。DLBCL 中典型 t(14:18)的病例只有2例,明显低于国外报道。用 FISH 方法检测 DLBCL中 IgH 重排阳性率为40.1%。16例 B 小淋巴细胞淋巴瘤均未发现13q14缺失,只发现2例有13q10异常。11例血管免疫母细胞性 T 细胞淋巴瘤中只有3例核型异常。结论我国淋巴瘤的病理类型分布与欧美国家有明显不同。尽管 DLBCL 染色体异常类型基本与国外相似,但 t(14;18)较少见。与国外报道相比,B 小淋巴细胞淋巴瘤和血管免疫母细胞性 T 细胞淋巴瘤染色体异常率较低,染色体异常类型也有差异。
Objective To investigate the relationship between chromosomal abnormalities in non-Hodgkin’s lymphoma (NHL) patients and WHO histopathological classification and to compare with NHL chromosomal abnormalities abroad. Methods The lymph node tissues of 155 patients with NHL were studied by means of conventional G-banding assay and fluorescence in situ hybridization (FISH). Results The common pathological types of 155 NHL patients were diffuse large B cell lymphoma (DLBCL) (59 cases, 38.1%), follicular lymphoma (27 cases, 17.4%), B small lymphocytic lymphoma , 10.3%), nonspecific peripheral T-cell lymphoma (13 cases, 8.4%), angioimmunoblastic T cell lymphoma (11 cases, 7.1%). Among 155 cases of NHL, 119 were chromosomal abnormalities (76.8%). Follicular lymphoma, B small lymphocytic lymphoma, DLBCL, anaplastic large cell lymphoma and precursor T lymphoblastic lymphoma chromosomal abnormalities were 96.3%, 87.5%, 86.4%, 83.3%, respectively, 83.3%. Complicated karyotype in DLBCL accounted for 86.3%, chromosomal abnormalities most affected chromosome 3,6,14,1, 41.2% 3q27 abnormalities, 43.1% cases of chromosome 1 abnormalities. 6q21, 6q23 and 6q25 abnormalities accounted for 23.5%. Only two cases of typical t (14:18) in DLBCL were significantly lower than those reported in foreign countries. The positive rate of IgH rearrangement detected by FISH in DLBCL was 40.1%. None of the 16 B small lymphocytic lymphomas found a 13q14 deletion, and only 2 had 13q10 abnormalities. Only 11 of the 11 cases of angioimmunoblastic T cell lymphoma had karyotype abnormalities. Conclusion The pathological type distribution of lymphoma in our country is obviously different from that in Europe and the United States. Although the types of DLBCL chromosome abnormalities are similar to those abroad, t (14; 18) is less common. Compared with foreign reports, B small lymphocytic lymphoma and angioimmunoblastic T-cell lymphoma chromosomal abnormalities low rate of chromosomal abnormalities are also different.