Study Of Clinicopathological Feature And The Expression Of Oct2, Bcl10 And IRTA1 In Gastric MALT Lymphoma

Objective:To study the significance for either diagnosis and differential diagnosis or the relation to clinicopathological feature and prognosis by detecting the expression of Oct2 and BcllO protein in gastric MALT lymphomas. To analysis the significance for diagnosis and differential diagnosis by detecting the expression of IRTAl in the level of protein and transcription, respectively.To investigate the role of BcllO mutation in pathogenic mechanism by sequencing the PCR product of bl10 gene in gastric MALT lymphoma.Methods: 方法:1. The clinicopathological and follow-up data of gastric MALT lymphomas and gastric MALT lymphoma accompanying DLBCL transformation were collected. The morphologic study on paraffin-embedded tissue sections were performed.2. Immunohistochemical analysis of a series of antibody comprised of Oct2 and BcllO and IRTAl were performed.3. BcllO mutation were detecting on some specimens with nuclear BcllO expression and dissemination to regional lymph nodes by sequencing PCR product of BcllO exon3.4. The expression of IRTAl mRNA were detected on some specimens with IRTAl protein negative expression by ISHH.Result:1. The most basic feature of gastric MALT lymphoma was infiltration of neoplastic marginal zone B-cells. The others were included such as lymphoepithelial lesion and follicular colonization, and so on. The rate of dissemination to regional lymph nodes were up to 37.7 %(19/51).2. The ratio of gastric MALT lymphoma and MALT lymphoma accompanyingDLBCL transformation was 2.43 .' 1. The 5-year and 10-year overall survival of was 90.3%(28/31) and 50%(6/12) in gastric MALT lymphomas, respectively. The 5-year overall survival of gastric DLBCL accompanying MALT lymphomas was 38.5%(5/13). There were statistically significant difference between gastric MALT lymphomas and those accompanying DLBCL transformation by Log-Rank test (X2 =11.32 p<0.05).3. The levels of expressed Oct2 was statistically significant difference between the gastric MALT lymphoma and those accompanying DLBCL transformation. (X2=8.827 p<0.05).4. The nuclear positive rate of BcllO was 60.8%(31/51) in gastric MALT lymphomas. It was statistically significant difference between different invasive depth as well as there were or no the dissemination to lymph node.5. There were not mutation of bcllO exon3 in 15 cases of BcllO nuclear positive and dissemination to regional lymph nodes in gastric MALT lymphoma.6. The positive rate of expressed IRTA1 protein were 86.3% (44/51). The positive rate of expression of IRTA1 mRNA which IRTA1 protein expressed negatively were 71.4%(5/7) in gastric MALT lymphoma.Conclusions:1. A high levels of Oct2 expression were correlation to the tendency that MALT lymphoma be of transformation to DLBCL in stomach.2. The nuclear BcllO expression is useful to differential diagnosis between MALT lymphoma and reactive hyperplasia of lymphoid tissue in stomach. Some cases with nuclear BcllO expression are associated with their increased aggressive abibility and easy to spread to lymph node.3. bcllO mutation is infrequent which suggest that BCL10 mutation were not critical to the pathogenic mechanism and progression in gastric MALT lymphomas.4. To detect the expression of IRTA1 protein and mRNA is useful to diagnosis and differential diagnosis of MALT lymphoma. IRTA1 may serve as a promisingdiagnostic marker for this distinct subtype of lymphoma.