眼附属器结外边缘区B细胞淋巴瘤的浆细胞分化:分析肿瘤的浆细胞分型及136例患者的预后重要性

作     者：Coupland S.E. Hellmich M. Auw-Haedrich 王海燕 

作者机构：Institute of Pathology Char'.-Medical Faculty Berlin Campus Benjamin Franklin Germany Hindenburgdamm 30 D-12203 Berlin Germany Dr. 

出 版 物：《世界核心医学期刊文摘（眼科学分册）》 (Digest of the World Core Medical Journals:Ophthalmology)

年 卷 期：2005年第1卷第8期

页      面：46-47页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：眼附属器 浆细胞病 淋巴瘤 分化型 多发性骨髓瘤 边缘区 相关抗原 免疫球蛋白 多因素分析 癌基因 

摘      要：Aim: To determine (a) the expression of plasma cell related antigens in extran odal marginal zone B cell lymphomas (EMZL) of the ocular adnexa; and (b) the pro gnostic value of plasmacellular differentiation in these tumours. Methods: A con secutive case series of 136 ocular adnexal EMZL obtained from three ocular patho logy centres over 20 years was analysed retrospectively. An extensive immunohist ochemical panel, including the plasma cell related antigens VS38c, CD38, CD138, multiple myeloma oncogene-1-protein (MUM1/ IRF4), and CREB binding protein (CB P) was performed. EMZL were defined as “plasmacellular differentiatedon the b asis of morphological features, evidence of cytoplasmic immunoglobulin, negativi ty for BSAP/PAX5, and expression of at least one of the investigated plasma cell related antigens. Controls included normal or hyperplastic lymphatic tissues. D etailed clinical data were collected for most patients, and compared with the re sults of immunohistochemistry. The end points considered for statistical analysi s were development of local tumour recurrence, development of systemic disease, and lymphoma related death. Results: 57 (42%) of the 136 ocular adnexal EMZL sh owed a plasmacellular differentiation; 45 of these plasmacytoid cases were prima ry tumours. In contrast with most admixed normal plasma cells, which displayed c o-expression of MUM1/IRF4, Vs38c, CD38, CD138, and CBP, the plasmacellular diff erentiated EMZL tumour cells demonstrated co-expression of all five plasma cell related antigens in only six of 57 (11%) plasmacellular differentiated ocular adnexal EMZL. The most commonly expressed plasma cell related antigen was MUM1/I RF4, immunoreactivity being seen in 56/57 (98%) plasmacellular differentiated E MZL examined. Although the association of plasmacellular differentiation in prim ary ocular adnexal EMZL and disseminated disease was statistically significant o n univariate analysis (p=0.042), this was weaker on multivariate analysi