Non-Hodgkin lenfomalarda güncel sınıflama ve immünohistokimyasal değerlendirme
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Dosyalar
Tarih
2013
Yazarlar
Dergi Başlığı
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Son yıllarda Diffüz büyük B hücreli lenfomalar genetik veya immünohistokimyasal çalışmalarla germinal merkez kökenli ve aktive B hücre kökenli olarak alt tiplere ayrılmaktadır. Germinal merkez kökenli olgularda sağkalım süresinin daha uzun olması bu ayırımı önemli kılmaktadır. FOXP1; aktive B hücre kökenli tipte pozitif saptanan bir transkripsiyon faktörü olup, çalışmalar artmış ekspresyonunun prognozu kötü yönde etkilediğini ortaya koymaktadır. Trakya Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı'nda 1998-2011 yılları arasında tanı almış 168 B hücre immünfenotipli Hodgkin dışı lenfoma olgusu incelendi. Olgular Dünya Sağlık Örgütü 2008 Lenfoma Sınıflaması'na göre tekrar değerlendirildi. Diffüz büyük B hücreli lenfoma olgularına immünohistokimyasal boyama yapılarak Hans, Choi ve Visco-Young algoritmalarına göre germinal merkez kökenli ve aktive B hücre kökenli olarak alt tipleme yapıldı. Ayrıca tüm Diffüz büyük B hücreli lenfoma olgularına anti-GCET2 ve LMO2 antikorları ile immünohistokimyasal boyama yapılarak sonuçları değerlendirildi. Çalışma kapsamımızdaki Diffüz büyük B hücreli lenfoma, Foliküler lenfoma, Marjinal zon lenfoma, Mantle hücreli lenfoma, Burkitt lenfoma ve Küçük lenfositik lenfoma olgularında istatistiksel olarak FOXP1 ekspresyonu açısından anlamlı farklılık bulunmadı. Diffüz büyük B hücreli lenfoma olguları Hans, Choi ve Visco-Young algoritmalarına göre sınıflandığında Choi ve Visco-Young algoritmaları arası çok güçlü uyum bulundu. Visco-Young algoritmasının uygulanabilirlik ve değerlendirme açısından rutin kullanıma daha uygun olduğu sonucuna varıldı. İmmünohistokimyasal değerlendirmede çıkan sorunlar nedeniyle GCET2'nin algoritmada kullanımının uygun olmadığı düşünüldü. Anti-LMO2 antikoru ile ise germinal merkez kökenli Diffüz büyük B hücreli lenfoma olgularının anlamlı bir şekilde saptandığı ve gerekli görüldüğü takdirde Visco-Young algoritmasında alternatif biomarker olabileceği ya da algoritmada farklı bir yerde kullanılabileceği görüşüne varıldı.
Abstract
In recent years, the diffuse large B cell lymphoma cases are separated into germinal center B-cell and activated B-cell subtypes on the basis of the genetics and immunohistochemistry studies. The discrimination of the subtypes is important because of the high survival rates of the germinal center B-celllike cases. FOXP1 is a transcription factor determined positive in diffuse large B cell lymphoma with activated B-cell subtype and some studies reported its negative effect on the prognosis. 168 cases of B-cell immune phenotype Non-Hodgkin lymphoma diagnosed between 1998-2011 were studied in Trakya University, Faculty of Medicine, Department of Pathology. The cases were evaluated according to the 2008 World Head Organization classification of lymphomas. The Diffuse large B cell lymphoma cases stained with immunohistochemistry techniques and separated into subtypes of germinal center B-cell and activated B-cell with respect to Hans, Choi and Visco-Young algorithms. Furthermore, all cases of diffuse large B cell lymphoma were stained with anti-GCET2 and LMO2 antibodies and the results were evaluated. There was no significant statistical difference in the cases of diffuse large B cell lymphoma, Follicular lymphoma, Marginal zone lymphoma, Mantle cell lymphoma, Burkitt lymphoma and Small lymphositic lymphoma in terms of FOXP1 expression. There was strong correlation between Choi and Visco-Young algorithms in Diffuse large B cell lymphomacases. It is concluded that the Visco-Young algorithm is more suitable in terms of practicability and evaluation. Because of the problems in immunohistochemistry evauation, the use of GCET2 in the algorithm was found unsuitable. In germinal center B-cell like diffuse large B cell lymphoma Anti-LMO2 antibody was found significantly, so if needed it can be used as an alternative biomarker in Visco-Young algorithm or can be used in a different place in the algorithm.
Abstract
In recent years, the diffuse large B cell lymphoma cases are separated into germinal center B-cell and activated B-cell subtypes on the basis of the genetics and immunohistochemistry studies. The discrimination of the subtypes is important because of the high survival rates of the germinal center B-celllike cases. FOXP1 is a transcription factor determined positive in diffuse large B cell lymphoma with activated B-cell subtype and some studies reported its negative effect on the prognosis. 168 cases of B-cell immune phenotype Non-Hodgkin lymphoma diagnosed between 1998-2011 were studied in Trakya University, Faculty of Medicine, Department of Pathology. The cases were evaluated according to the 2008 World Head Organization classification of lymphomas. The Diffuse large B cell lymphoma cases stained with immunohistochemistry techniques and separated into subtypes of germinal center B-cell and activated B-cell with respect to Hans, Choi and Visco-Young algorithms. Furthermore, all cases of diffuse large B cell lymphoma were stained with anti-GCET2 and LMO2 antibodies and the results were evaluated. There was no significant statistical difference in the cases of diffuse large B cell lymphoma, Follicular lymphoma, Marginal zone lymphoma, Mantle cell lymphoma, Burkitt lymphoma and Small lymphositic lymphoma in terms of FOXP1 expression. There was strong correlation between Choi and Visco-Young algorithms in Diffuse large B cell lymphomacases. It is concluded that the Visco-Young algorithm is more suitable in terms of practicability and evaluation. Because of the problems in immunohistochemistry evauation, the use of GCET2 in the algorithm was found unsuitable. In germinal center B-cell like diffuse large B cell lymphoma Anti-LMO2 antibody was found significantly, so if needed it can be used as an alternative biomarker in Visco-Young algorithm or can be used in a different place in the algorithm.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Diffüz Büyük B Hücreli Lenfoma, Germinal Merkez, LMO2, GCET2, FOXP1, Germinal Center, Diffuse Large B Cell Lymphoma
