Fc受体样4蛋白在唾液腺黏膜相关淋巴组织结外边缘区B细胞淋巴瘤中的表达及意义

doi:10.3969/j.issn.1005-4979.2020.03.007

摘要/Abstract

摘要：

目的: 通过检测唾液腺黏膜相关淋巴组织结外边缘区B细胞淋巴瘤（extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue B cell lymphoma, MALT 淋巴瘤）中Fc受体样4（Fc receptor-like 4，FCRL4）蛋白的表达，分析其表达及分布特点与临床病理指标、预后等的相关性。方法: 筛选2005—2013经病理确诊为唾液腺MALT淋巴瘤的病例作为实验组；以唇腺良性淋巴上皮病（benign lymphoepithelial lesions，BLEL）、大唾液腺BLEL及弥漫性大B细胞淋巴瘤（diffuse large B cell lymphoma，DLBCL）作为对照组。免疫组织化学（immunohistochemistry，IHC）法检测FCRL4蛋白表达。采用SPSS 17.0软件对FCRL4在实验组、对照组的表达及其与临床病理指标之间的关系进行分析，应用Kaplan-Meier法分析FCRL4表达与总体生存率之间的关系。结果: 共收集到72例唾液腺MALT淋巴瘤。FCRL4表达主要定位于淋巴细胞的细胞膜和细胞浆，阳性细胞主要分布在上皮巢内及周边，且在唾液腺MALT淋巴瘤中的表达率显著高于唇腺BLEL（P=0.013）、大唾液腺BLEL（P=0.003）及DLBCL（P=0.001）。FCRL4蛋白表达与临床病理指标、总体生存率之间均无明显相关性（P>0.05）。结论: 唾液腺MALT淋巴瘤中FCRL4主要表达于邻近上皮的淋巴细胞中，该类细胞可能与唾液腺MALT淋巴瘤的发生相关，可作为该肿瘤辅助诊断的指标。

Abstract:

Objective: To analyze the expression and distribution characteristics of Fc receptor-like 4 (FCRL4) protein and its correlation with clinicopathologic features, prognosis in salivary gland extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue B cell lymphoma(MALT lymphoma). Methods: Totally, 72 cases between 2005 to 2013 of MALT lymphoma of salivary gland were collected as the experimental group. Benign lymphoepithelial lesions(BLEL) of labial gland, BLEL of major salivary gland, and diffuse large B cell lymphoma (DLBCL) were selected randomly as the control group. The expression of FCRL4 in MALT lymphoma were examined by immunohistochemistry. The expression of FCRL4 between experimental group and control group, the correlation between expression of FCRL4 and clinicopathologic features, were analyzed by SPSS 17.0 software. And the correlation between expression of FCRL4 and the survival rate was analyzed by using Kaplan-Meier method. Results: The expression of FCRL4 was detected in the cytoplasm and cell membrane of lymphocyte, and the positive cells mainly located beside the epithelial islands. The expression intensity of FCRL4 in salivary gland MALT lymphoma was significantly stronger than BLEL of labial gland (P=0.013), BLEL of major salivary gland (P=0.003) and maxillofacial DLBCL (P=0.001) respectively. There was no statistical difference between the expression of FCRL4 in MALT lymphoma and the clinicopathologic features (P>0.05), and also between expression of FCRL4 and overall survival rate (P>0.05). Conclusion: In salivary gland MALT lymphoma, expression of FCRL4 demonstrated in B lymphocytes nearby the epithelial island, and these cells with FCRL4 expression may be associated with the occurrence of MALT lymphoma in salivary gland. Protein expression of FCRL4 could be a useful marker for the diagnosis of MALT lymphoma.

Key words: Fc receptor-like 4(FCRL4), extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue B cell lymphoma, benign lymphoepithelial lesions, immunohistochemistry

中图分类号:

R782
R739.8

顾挺, 张春叶, 胡宇华, 夏荣辉, 田臻, 王丽珍, 李江. Fc受体样4蛋白在唾液腺黏膜相关淋巴组织结外边缘区B细胞淋巴瘤中的表达及意义[J]. 《口腔颌面外科杂志》, 2020, 30(3): 163-167.

GU Ting, ZHANG Chunye, HU Yuhua, XIA Ronghui, TIAN Zhen, WANG Lizhen, LI Jiang. Expression and Significance of FCRL4 in Salivary Gland Extranodal Marginal Zone Lymphoma of Mucosa-associated Lymphoid Tissue B Cell Lymphoma[J]. 《Journal of Oral and Maxillofacial Surgery》, 2020, 30(3): 163-167.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2020/V30/I3/163

图/表 4

表1 72例唾液腺MALT淋巴瘤的临床病理资料

Table 1 Clinicopathological characteristics of MALT lymphoid of salivary gland

特征		例数/例	占比/%
性别	女	53	73.61
	男	19	26.39
年龄/岁	<50	26	36.11
	≥50	46	63.89
部位	腮腺	54	75.00
	腭部	8	11.11
	下颌下腺	3	4.17
	其他	7	9.72
是否合并SS	否	48	66.67
	是	24	33.33
是否行放化疗	是	29	40.28
	否	43	59.72
Lugano分期	IE	61	84.72
	IIE	9	12.50
	IV	2	2.78

表2 唾液腺MALT淋巴瘤、唇腺BLEL、大唾液腺BLEL及颌面部DLBCL中FCRL4的蛋白表达（例）

Table 2 The comparison of expression of FCRL4 in MALT lymphoma of salivary gland, BLEL of labial gland, BLEL of salivary gland and maxillofacial DLBCL(case)

组织类型	FCRL4			P值
组织类型	阴性	低表达	高表达	P值
唾液腺MALT淋巴瘤	4	40	28
唇腺BLEL	7	3	0^*	0.013
大唾液腺BLEL	10	9	1^*	0.003
颌面部DLBCL	27	3	0^*	0.001

图1 FCRL4在唾液腺MALT淋巴瘤及颌面部DLBCL中的表达注：A. 唾液腺MALT淋巴瘤HE染色图，上皮岛（红色星星）内及周边可见肿瘤性淋巴细胞浸润（HE×20）；B. 唾液腺MALT淋巴瘤中FCRL4蛋白表达主要集中在上皮岛（红色星星）周边，远离上皮岛区域阳性表达细胞较少（IHC×20）；C. 高倍镜下可见上皮岛（红色星星）内及周边肿瘤细胞均表达FCRL4 （IHC×40）；D. DLBCL中FCRL4的免疫组织化学染色图，肿瘤性B细胞中，FCRL4呈弱阳性表达（IHC×20）。

Figure 1 The expression of FCRL4 in salivary gland MALT lymphoma and maxillofacial DLBCL

图2 FCRL4在唇腺BLEL及大唾液腺BLEL中的表达情况注：A. 唇腺BLEL组织HE染色图，在导管上皮细胞周边（黄色箭头）有灶性淋巴细胞聚集（HE×20）；B.唇腺BLEL中FCRL4免疫组织化学染色图，导管上皮细胞周围（黄色箭头）可见少量淋巴细胞表达FCRL4（IHC×40）；C. 大唾液腺BLEL镜下表现，病变主要由增生上皮岛（黑色箭头）和淋巴组织构成（HE×40）；D.大唾液腺BLEL中FCRL4免疫组织化学染色图，上皮岛周边（黑色箭头）显示有少量FCRL4表达（IHC×40）。

Figure 2 The expression of FCRL4 in BLEL of labial grand and salivary gland

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