黏膜相关淋巴组织结外边缘区淋巴瘤病理特征、IgM 表达及与MYD88 L265P突变的相关性研究

目的 探讨不同部位黏膜相关淋巴组织结外边缘区淋巴瘤（MALT 淋巴瘤）的病理特征、并分析IgM 表达与MYD88 L265P 突变的相关性。方法 对发生在不同部位的65 例MALT淋巴瘤患者的标本进行病理组织学及免疫组化分析，选取其中可行分子生物学研究的26 例标本进行IgM 表达检测，以测序法检测了MYD88 L265P 的突变状况，并研究了IgM 表达与MYD88 L265P 突变间的相关性。结果 65 例患者的病变部位包括胃18 例、涎腺10 例、肺9 例、肠道8 例、眼7 例、甲状腺5 例、其他部位8例。不同器官的病变具有相似的组织学和大部分免疫组化表达，但Bcl-2 的表达在肺（6/9）和甲状腺（2/5）与总体（56/65）相比均有统计学差异（均P ＞0.05）。26 例标本中有16 例IgM 呈阳性，而发生MYD88 L265P 的突变的病例只有1例，两者无相关性（P=0.615）。结论 发生在不同的部位的MALT 淋巴瘤具有相似的病理学特征，MYD88 L265P 的突变率在MALT 淋巴瘤较低，且与IgM 表达无明显相关性。

Pathological features, IgM expression and MYD88 L265P mutation in MALT lymphoma

Objective To investigate the pathological features, IgM expression and MYD88 L265P mutation of extranodal marginal zone B cell lymphoma (MALT lymphoma). Methods The clinical and pathological data of 65 cases of MALT lymphoma were collected and analyzed. MYD88 gene mutation was determined by PCR and DNA sequencing, IgM expression was detected by immunohistochemistry in 26 cases of MALT lymphoma. Results MALT lymphoma was initially diagnosed in stomach (n=18), salivary glands (n=10), lung (n=9), intestine (n=8), conjunctiva (n=7), thyroid (n=5) and other sites (n=8). The histological and immunophenotypic features of the lymphoma involving different organs were similar. Among 26 cases MYD88 L265P mutation was detected in 1 case and IgM was expressed in 16 cases. Conclusion MALT lymphomas involving different organs have similar pathological features. The frequency of MYD88 L265P mutation is low, and the correlation between MYD88 gene mutation and IgMexpression is not found.