Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Diffüz Büyük B Hücreli Lenfomada Germinal Merkez B Hücre-Benzeri ve Germinal Merkez-Dışı B Hücre-Benzeri Orijinin Araştırılması
Investigation of Germinal Center B Cell-Like and Germinal Non-Center B Cell-Like Origin in Diffuse Large B-Cell Lymphoma
Tuğba ÖZÇEREZCİa, Yılmaz BAŞa
aPatoloji Kliniği, Hitit Üniversitesi Erol Olçok Eğitim ve Araştırma Hastanesi, Çorum, TÜRKİYE
Turkiye Klinikleri J Med Sci. 2019;39(3):310-8
doi: 10.5336/medsci.2018-63714
Article Language: TR
Full Text
ÖZET
 Amaç: İmmünohistokimyasal (İHK) olarak CD10, BCL-6, MUM-1/IRF-4 antikor ekspresyonlarının ve Ki-67 proliferasyon indeks oranlarının germinal merkez (GM) B hücre benzeri ve GM-dışı B hücre benzeri diffüz büyük B hücreli lenfoma (DBBHL) ayrımında kullanılıp kullanılamayacağının belirlemesidir. Gereç ve Yöntemler: 18 Ocak 2008 ile 03 Eylül 2012 tarihleri arasında, Dr. Abdurrahman Yurtarslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi Patoloji Bölümünde, lenf düğümünde DBBHL tanısı konulmuş 66 hasta çalışmaya dâhil edildi. İmmünohistokimyasal (İHK) olarak CD10, BCL-6, MUM-1/IRF-4 antikorlarının ekspresyon oranları ve yaş, cinsiyet, anatomik yerleşim dağılımları, antiapopitotik protein olan BCL-2 ve Ki-67 indeksi yönünden incelendi. Bulgular: Erkek hasta sayısı 35 (%53), kadın hasta sayısı 31 ve ortalama yaş 61,3±14,2 (27-88) yıl idi. En sık lokalizasyon servikal bölgeydi. Sırasıyla, CD10, BCL-6, MUM1/IRF4 ve BCL-2, 66 hastanın %18,2, %65,2, %78,8, ve %93,9'unda pozitif iken, %81,8, %34,8, %21,2 ve %6,4 hastada negatif bulundu. Ki-67 proliferasyon indeksi ortalama 76,4±15,8 idi. On yedi (%25,8) hasta GM B hücre benzeri, 49 (%74,2)'u GM-dışı B hücre benzeri DBBHL tanısı aldı. Sonuç: GM B hücre benzeri ve GM-dışı B hücre benzeri DBBHL ayrımında kullanılabilecek İHK belirteçlerinin CD10 ve MUM1/IRF4 olduğu, BCL-6'nın ise belirleyici etkisinin bulunmadığı sonucuna varılmıştır. Ki-67 proliferasyon indeksinin GM B hücre benzeri ve GM-dışı B hücre benzeri DBBHL ayrımında belirleyici etkisi bulunmamaktadır.

Anahtar Kelimeler: Diffuz buyuk B hucreli lenfoma; immunohistokimya; CD10; BCL-6; MUM-1/IRF-4; Ki-67 indeks
ABSTRACT
 Objective: We aimed to determine whether CD10, BCL-6, MUM-1/IRF-4 antibody expressions and Ki-67 proliferation index ratios as immunohistochemical (IHC) can be used to differentiate germinal center B cell-like (GCB) and non-germinal center B cell-like (non-GCB) diffuse large B cell lymphoma (DBBHL) in this study. Material and Methods: Between 18 January 2008 and 03 September 2012, the study included 66 patients diagnosed with DBBHL in the lymph node of the Department of Pathology, Dr. Abdurrahman Yurtarslan Ankara Onkoloji Training and Research Hospital. Immunohistochemical (IHC) expression of CD10, BCL-6, MUM-1/IRF-4 antibodies and age, sex, distribution of anatomic location, anti-apoptotic protein BCL-2 and Ki-67 index were examined. Results: The number of male patients was 35 (53%) and the number of female patients was 31 and the mean age was 61.3±14.2 (27-88). The most common localization was the cervical region. Respectively, CD10, BCL-6, MUM1/IRF4 and BCL-2 were positive in 18.2%, 65.2%, 78.8% and 93.9% of 66 cases, negative in 81.8%, 34.8%, 21.2% and 6.4% of 66 cases. The mean Ki- 67 proliferation index was 76.4±15.8. 17 (25.8%) cases were diagnosed as GCB and 49 (% 74.2) cases were diagnosed as non-GCB DBBHL. Conclusion: It was concluded that IHC markers which can be used in the differentiation of GCB and non-GCB DBBHL are CD10 and MUM1/IRF4, and BCL-6 has no determining effect. The Ki-67 proliferation index has no determining effect on the differentiation of GCB and germinal non-GCB DBBHL.

Keywords: Diffuse large B cell lymphoma; immunohistochemistry; CD10; BCL-6; MUM-1/IRF-4; Ki-67 endex
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