摘要目的 对原发性中枢神经系统弥漫大B细胞淋巴瘤(CNS DLBCL)进行Hans、Choi和Tally分型比较研究,探讨其与预后的关系.方法 应用免疫组织化学染色技术检测CD20、CD3、CD10、Bcl-6、Mum-1、CD5、Bcl-2、Ki-67、FOXP-1、GCET-1、BLIMP-1和LMO-2在47例CNS DLBCL中的表达,并进行Hans、Choi和Tally分型,分析其与预后的关系.结果 47例CNS DLBCL中,Bcl-2、CD10、Bcl-6、Mum-1、GCET-1、BLIMP-1、FOXP-1和LMO-2的表达率分别为46.8％、4.3％、70.2％、53.2％、36.2％、4.3％、63.8％和19.2％；Ki-67的阳性率为30％～95％,中位数为80％,其中12例(25.5％)≥90％.Hans分型中,生发中心B细胞(GCB)型16例(34.0％),非生长中心B细胞(nonGCB)型31例(66.0％)；Choi分型中,GCB型16例(34.0％),活化B细胞(ABC)型31例(6.0％)；Tally分型中,GCB型6例(12.8％),non-GCB型41例(87.2％).47例CNS DLBCL患者的１、2和5年生存率分别为34.0％、15.6％和12.5％.Hans、Choi和Tally分型不影响CNS DLBCL患者预后的相关因素(均P＞0.05).结论 Hans、Choi和Tally分型与CNS DLBCL的预后均无明显相关性.术后放化疗和甲氨蝶呤治疗与预后相关.

abstractsObjective To analyze the subtypes of primary diffuse large B cell lymphoma of the central nervous system (CNS DLBCL) and to explore the relationship between the subtype classification and prognosis.Methods Immunohistochemical staining was used to determine the expression of CD20,CD3,CD10,Bcl-6,Mum-1,CD5,Bcl-2,Ki-67,FOXP-1,GCET-1,BLIMP-1 and LMO-2 antigens on paraffinembedded sections of 47 cases. Hans,Choi and Tally subtypes were classified,and univariate and multivariate analyses were used to elucidate the relationship between the subtypes and prognosis.Results In the 47 cases,the expression of Bcl-2 in the tumor cells was 46.8％,CD10 4.3％,Bcl-6 70.2％,Mum-1　53.2％,GCET-1 36.2％,BLIMP-1 4.3％,FOXP-1 63.8％ and LMO-2 19.2％.The positive rate of Ki-67 was 30％ to 95％,with a median of 80％,of which 12 cases (25.5％) was ≥ 90％.The Hans subtype classification showed 16 cases (34.0％) were of GCB type and 31 cases (66.0％) of non-GCB type.The Choi subtype classification showed 16 cases (34.0％) were of GCB type and 31 cases (66.0％) of ABC type.The Tally subtype classification showed 6 cases ( 12.8％ ) were of GCB type and 41 cases (87.2％)of non-GCB type.Conclusions The results of this study show that there is no significant correlation between the three subtypes and prognosis.The prognosis is correated with post-operative radiotherapy,chemotherapy and MTX therapy.