摘要目的 对原发性中枢神经系统弥漫性大B细胞淋巴瘤分型,并探讨其组织起源和预后相关意义.方法 应用免疫组织化学EnVision二步法,检测CD10、bcl-6、MUM-1、CD138和FOXP1在47例原发性中枢神经系统弥漫性大B细胞淋巴瘤中的表达情况.结果 CD10、bcl-6、MUM-1、CD138和FOXPI表达率分别为6.4%、53.2%、91.5%、0和93.6%.47例中有43例(91.5%)为活化B细胞表型:21例(44.7%)为活化的生发中心亚型,22例(46.8%)为活化的非生发中心亚型.该分型及FOXP1的表达与预后无明显相关性(P=0.279和P=0.154).结论 原发性中枢神经系统弥漫性大B细胞淋巴瘤绝大多数为活化B细胞亚型,是系统性弥漫性大B细胞淋巴瘤中一种相对同质性的亚型,推测其组织起源是生发中心末期至后生发中心早期的B细胞.

abstractsObjective To investigate the histogenetic origin of primary central nervous system diffuse large B-cell lymphoma(DLBCL)with respect to the stage of B-cell differentiation,and identification of the relevant prognostic markers.Methods Immunohistochemical staining(EnVision method)for CD10,bcl-6.MUM-1.CD138 and FOXP1 antigens was performed on 47 paraffin-embedded sections.ResultsCD10.bcl-6,MUM-1 and FOXP1 expression in the tumor cells were 6.4%,53.2%.91.5%and 93.6%respectively.There was no expression of CD138 in all the cases.Among the 47 patients.43 cases (91.5%)showed an activated B-cell-like(ABC)phenotype:21(44.7%)were bcl-6+ and MUM-1+,suggesting an"activated germinal center(GC)B-cell-like"in origin;22(46.8%)were exclusively MUM-1+,suggesting an"activated non-GCB"in origin.No significant correlation of the classification and FOXP1 expression found on the outcome(P=0.279 and P=0.154).Conclusions Most primary central nervous system DLBCL are shown belonging to the ABC subgroup,suggesting that primary central nervous system DLBCL is quite similar to a DLBCL subset,which is derived from late GC to early post.GC B cell.The classification and FOXPl expression do not show prognostic value in primary central nervous system DLBCL.