| Background:Extranodal marginal zone B cell lymphoma of mucosa associated lymphoid tissue, shortened form is MALT lymphoma.In recent years,the incidence rate of it has increased tendency,just below the diffuse large B cell lymphoma and follicular lymphoma, and is the one of common B cell lymphoma.The patients are aged and elderly people gastrointestinal tract is the most common location,also can be seen in saliary gland, thyroid, nose pharynx, lung, ocular adnexal and skin,the clinical process is inert and low-grade malignant.At present, about the research of MALT lymphoma, the hot spot concentrate on the molecular genetics changes of MALT lymphoma.scholars at home and abroad generally agree that:the molecular genetics changes of MALT lymphoma play a key role in the occurrence and development of it. the major molecular genetics changes of MALT lymphoma is t(11;18)(q21;q21),t (14;18)(q32;q21)and t(1;14)(p22;q32),about them, t(11;18)(q21;q21) and t (14;18)(q32;q21) can happen to gastrointestinal tract MALT lymphoma, the majority is the former. So,the research about the molecular genetics of gastrointestinal tract MALT lymphoma, mainly are the abnormal of t(11;18)(q21;q21),and as follow is the genes involved of the abnormal:API2 gene,MALT1 gene,AP12-MALT1 fusion gene, above that gene,can activat NF-κB signal conduction passage directly or indirectly, the abnormal activation of NF-κB signal conduction passage is play a very important role in the occurrence and development of gastrointestinal tract MALT lymphoma.For some preoperative small biopsy gastrointestinal tract MALT lymphoma, if it is the case which pathological changes is typical, combine immunohistochemical can make clear diagnosis;but pathological changes of some cases is not typical, it is difficult in diagnosing MALT lymphoma on the basis of the immunophenotype.For this reason, through the molecular biology technology, detect the incidence of gene that is related to gastrointestinal tract MAIT lymphomas in gastrointestinal tract MAIT lymphomas,and to explore theirs value in pathological diagnosis of gastrointestinal tract MAIT lymphomas.this study retrospective analyse the clinical data, organization pathological morphology and histopathology immunophenotype results of 43 case gastrointestinal tract MAIT lymphomas,and detect the incidence of APl2-MALT1 fusion gene caused by t(11; 18) in paraffin embedding specimens of gastrointestinal tract MAIT lymphomas, and to explore theirs value in pathological diagnosis of gastrointestinal tract MAIT lymphomas.Materials and methods:1. Collect patients date about 43 paraffin embedding specimens of gastrointestinal tract MAIT lymphomas of the pathology department of the first hospital of Zhengzhou University, which is made a definite diagnosis by HE and immunohistochemical staining. There are 30 paraffin embedding specimens of stomach MAIT lymphomas,13paraffin embedding specimens of intestines MAIT lymphomas.2. Retrospective analysis the clinical data and pathological data about43 gastrointestinal MALT lymphoma.3. For 43 paraffin embedding specimens of gastrointestinal tract MAIT lymphomas, extract RNA from paraffin embedding tissue by acidic phenolic chloroform method, through reverse transcription synthesis cDNA, and through reverse transcription- polymerase chain reaction to detect the incidence of AP12-MALT1 fusion gene.4. Detect the sequencing of the fusion gene through reverse transcription- polymerase chain reaction to.amplificate.5. Statistical analyses:The SPSS 13.0 statistical software was used. The mean±tandard deviation (X±S) was used to describe the measurement data; Differences in unordered categorical data were evaluated for significance by the Chi-square test or Fisher's exact test. Values of P<0.05 were considered statistically significant.Results:1.Among 43 gastrointestinal tract MAIT lymphomas, male patients 28 cases, female patients 15 cases, age in between 19 years old and 85 years old, average age 51.6 years old, median age 54.0 years old. There are 30 paraffin embedding specimens of stomach MAIT lymphomas,13paraffin embedding specimens of intestines MAIT lymphomas.2. In gastrointestinal tract MAIT lymphomas(n=43), the results of IHC is that the positive rate of CD20 is 100%(43/43), the positive rate of CD79a is 65.1%(28/43),the negative rate of CD5 is 93.0%(40/43), the negative rate of CyclinD1 is 95.3%(41/43),the negative rate of CD 10 is 95.3%(41/43).3. Among 43 gastrointestinal tract MAIT lymphomas, microscopically manifestation is tumor cells distributed in lymphoid follicles peripheral, in a fringe area distribution or diffuse distribution; mononuclear sample B cells is the main component (n=8), center cell sample cells is the main component (n=7), the rest with a variety of cells mixed exist among them, can see follicular colonization(n=15) and Lymphatic epithelial lesions(n=17).4. In gastrointestinal tract MAIT lymphomas(n=43),detected the expression of the mRNA of the fusion gene API2-MALT1(n=6), the overall detection rate is 14.0% (6/43). Among them,five are gastric MAIT lymphomas(n=5), the detection rates is 16.7%(5/30), and one is intestines MAIT lymphoma (n=1),, the detection rates is 7.7 %(1/13)In chronic lymphnode inflammation(n=10), not detected the expression of the mRNA of the fusion gene API2-MALT1(n=0).There is correlation the fusion gene API2-MALT1 with gastrointestinal tract MAIT lymphomas (P<0.05),There were no correlation in gender, age, tumor location of gastrointestinal tract MAIT lymphomas (P>0.05).5. The MALT1 genes 1123bp breakpoints is one of fusion place the gene API2 and MALT1 gene rearrangement.Conclusions:1. Follicular colonization and Plasma cell differentiation and Lymphatic epithelial lesions, are the histologic features of MALT lymphoma, which can diagnose MALT lymphoma2. There is correlation the fusion gene API2-MALT1 with gastrointestinal tract MAIT lymphomas.3. In API2-MALT1 formed fusion genes, MALT1 gene 1123bp place has the breaking point.4. The API2-MALT1 fusion genes that help gastrointestinal MALT lymphoma treated by diagnosis. |
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