| Objective: To study the histopathological features, diagnosis and differentialdiagnoses of DLBCL and to correlate clinical prognosis with pathologic parameters andimmunophenotypes with an emphasis on BCL-2, BCL-6and C-MYC gene abnormalitiesand their values in predicting the status of gene translocation. Methods:100cases withpathologically confirmed diffuse large B cell lymphoma were enrolled in the firstAffiliated Hospital of Xin Jiang Medical University from2007to2014.Pathologicaldiagnosis and differential diagnosis was according to the2008WHO classification oftumors of haematopietic and lymphoid tissues. Envision two methods was invited to detectthe expression of CD3, CD5, CD10, CD20, CD23, CD34, CD43, Bcl-2, Bcl-6, MUM-1,CyclinD1and Ki-67in100cases of DLBCL. In situ hybridization were used for detectionof EBER in all cases. Specimens from100DLBCL were also analyzed for BCL-6, BCL-2and C-myc gene rearrangement using interphase fluorescent in situ hybridization(FISH).Statistical analysis was performed using the SPSS17.0software and differences wereconsidered significant when p<0.05.Results: DLBCL occurred in31-50years old，and theincidence rate is more for men than women．There are49patients in I+II stages，and51patients in III+IV stage. The LDH levels and β2-MG levels in III+IV stage wereobviously higher than that in I+II stage，and there was significant difference(P<0.05). CD3,CD10, CD20, CD34, Bcl-2, Bcl-6and MUM-1were positive in7.00%(7/100),11.00%(11/100),94.00%(94/100),79.00%(79/100),55.00%(55/100),89.00%(89/100),75.00%(75/100). According to Hans algorithm there are19cases of GCB and81cases of non-GCB. The detection of EBV: there were five cases were positive, including one caseof GCB, four cases of non-GCB.The genetic changes of BCL-2, BCL-6and C-myc geneswere executived by FISH in cases of100DLBCL.1case of DLBCL exist the t(14;18).7cases exist the BCL-2gene amplification.8cases exist the BCL-6gene rearrangement.2cases exist the C-myc gene rearrangement. Kaplan-Meier analysis showed that there wasstatistically significant difference according to the different factors,such as LDH level,primary tumor size, IPI score(P＜0.05).Cox regression analysis showed that LDH level,IPI score were risk indicators which could predict the prognosis of DLBCL. Conclusion:This study shows that the incidence of DLBCL is higher in male than that in female．nodalDLBCL is more frequent than Extra-nodal DLBCL. The most common pathologicalsubtype is centroblastic.The elevated of serum LDH level could be a poor prognosticfactor and associated with clinical stages and theβ2-MG levels might be also associatedwith clinic stage. Kaplan-Meier analysis showed that there was statistically significantdifference according to the different factors,such as LDH level, primary tumor size, IPIscore(P＜0.05).Cox regression analysis showed that LDH level, IPI score were riskindicators which could predict the prognosis of DLBCL. |
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