Anaplastic Large Cell Lymphoma: Correlation of Clinicopathologic Features with Diagnosis and Prognosis
摘要: 目的 :研究间变性大细胞淋巴瘤(ALCL)的临床病理特点和免疫表型,提高该疾病的早期诊断,并比较ALK+与ALK-在临床表现、治疗和预后的不同点。 方法 :对原诊断为ALCL的20例病例重新行组织学观察和免疫组织化学染色(ABC法)并复习相关文献。 结果 :20例中15例属于T/Null细胞表型,结合免疫组化诊断为ALCL,15例ALCL均强烈表达CD30;ALK阳性者9例,ALK的表达与患者性别,免疫分型、组织分型、临床分期无相关性;而与患者年龄及化疗敏感性具有相关性(P<0.05)。其余5例为B细胞表型(CD20强阳性),结合新的淋巴瘤分类标准,被诊断为弥漫性大B细胞淋巴瘤(DLBCL)。 结论 :间变性大细胞淋巴瘤中具有标志性的大细胞出现CD30、ALK和EMA阳性时,对ALCL的诊断具有重要价值;ALK+ALCL与ALK-ALCL在遗传特征,临床表现及治疗预后的不同,使其作为一种新的病理类型被提出具有合理性。Abstract: Objective : To investigate the clinicopathological and immunohistochemical characteristics of anaplastic large cell lymphoma (ALCL) and to compare the differences in clinical manifestation, treatment and prognosis between ALK-positive cases and ALK-negative cases. Methods : Histological and immunohistochemical staining methods (ABC method) were used to analyze 20 previously diagnosed cases of ALCL, and the correlated clinical data were reviewed. Results : Fifteen of the 20 cases were T/Null cell type (8 T and 7 Null) and were diagnosed as ALCL with immunohistochemistry. CD30 was strongly expressed in the 15 cases of ALCL. There were 9 ALK-positive cases. No correlation was found between ALK expression and sex, immunohistochemical type, histological type, or clinical stage. However, a significant correlation was found between ALK expression and age and sensitivity to chemotherapy (P <0.05). The remaining 5 cases were B cell type, and they were true DLBCL. Conclusion : Our study highlights the importance of histopathological features and the significance of CD30 and ALK in the diagnosis of ALCL. The differences between ALK-positive ALCL and ALK-negative ALCL suggest specific studies on these genes, including differences in clinical manifestation and remission rates after chemotherapy, should be performed.
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