Clinical Significance Of The Expression Of BCL10 And PCNA In Gastric Mucosa-associated Lymphoid Tissue Lymphomas

【Background and Objective】Gastric mucosa-associated lymphoid tissue lymphoma is a low grade malignant B cell lymphoma and origins from the marginal zone of lymphoid follicles.It usually occurs on the base of the lymphoma B-cell clone as a result of the persistent infection of Helicobactor Pylori.It has been found that BCL10 protein was expressed in the cytoplasms of B-cells in normal and reactive hyperplastic lymphoid tissues,whereas the protein localized to the nucleus in MALT lymphoma cells.Proliferating cell nuclear antigen(PCNA)is an objective index to evaluate cell proliferation state.Our study is to comprehend the clinical characteristic of gastric MALT lymphomas and to detect the clinical significance of the expression of BCL10 protein and PCNA.【Materials and Methods】The clinical data of 41 patients with gastric MALT lymphomas was reviewed,who accepted operation and got pathologic final diagnoses in PLA general hospital from March 1993 to July 2005.By using immunohistochemial methods,we detected the expression of BCL10 protein and PCNA in the samples of the above patients,and investigated the relations between their expression and clinal or pathological features and the correlation of the two expresssion statistically.【Results】The patients composed of 28 males and 13 females.Age range was from 17 to 80 years old and average age was(49.1±13.6)years old.MALT lymphomas often origined from antrum(34.1%).The HP infection rate was 80.5%.Epigastric ache(85.4%)was the most common presenting symptom. Endoscopy,GI X-ray series,abdominal computed tomography(CT)and abdominal sonography were used to detect the lesions before operations.The final diagnosis rate of the biopsy through endoscope(78%)was higher than that of any other method.Most patients were ones with stageⅠ(63.4%).Subtotal gastectomy (80.5%)was the main modus operandi.Post-operation five-year-survival rate was 86.4%and post-operation recurrence rate was 9.1%.The positive rate of nuclear BCL10 expression was 53.7%and positive rate of PCNA expression was 75.6%. The expression of PCNA was related to the HP infection,infiltration depth and clinical stage(P＜0.05).The nuclear BCL10 expression did not relate to any of the clincal or pathological features(P＞0.05),but the nuclear expression positive rate of BCL10 in the group that the lymphocyte infiltrated in the muscularis propria or serosa was higer than one infiltrated in the mucosa or submucosa,furthermore, one with advanced stage was higher than with early stage.The positive rate of nuclear BCL 10 expression in the group without HP infection(75.0%)was higher than one with HP infection(48.5%).There was no statistical correlation between nuclear BCL10 expression and PCNA expression(P＞0.05).【Conclusions】1 The nuclear BCL10 expression may contribute to the occurrence and development of gastric MALT lymphomas,and may become the sign of the diseases evolvement.2 PCNA expression can reflect the proliferation ability of lymphocyte well.United detection of BCL10 and PCNA will contribute to evaluate the prognosis and guide the therapy of gastric MALT lymphomas.3 The clinical manifestations of gastric MALT lymphomas have no specificities. Endoscopy and biopsy are the main diagnosis meathods before operation.Most of the leisions may be discovered early and the diseases may have well prognosis. The clinician and the endoscopist should improve the recognition of the disease in order to strive for early diagnosis and therapy.