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Objective:To improve the understanding of indolent mantle cell lymphoma (MCL).Methods:The data of a patient with indolent leukemic MCL in the Second Affiliated Hospital of Nanjing Medical University in May 2013 were collected. The cell morphology was analyzed by using cell smear, the flow cytometry was used to make immunophenotype analysis, the karyotype analysis was performed by usig cytogenetic technique, and polymerase chain reaction (PCR) was used to make the immunoglobulin gene analysis. At the same time, lymph node pathology and immunohistochemistry were also analyzed. The related articles published were reviewed to sum up the characteristics and the treatment of indolent MCL.Results:The male patient aged 60 years was obviously asymptomatic accompanied with slow disease progression, leukemic manifestation and without lymphadenopathy. He received pathological biopsy because of located lymphadenopathy in 2008. Small cell morphology, Kappa light chain immunophenotype, t(11;14) translocation showed after the cytogenetic examination, clonal immune globulin gene rearrangement and low Ki-67 positive index were identified. In situ MCL was diagnosed by retrospective pathology.Conclusions:Indolent MCL is extremely rare. It is typically asymptomatic with none or minimal nodal involvement, indolent disease course, leukemic phase with mild lymphocytosis, Kappa light chain expression, simple karyotype, classical or small cell morphology of tumor cells and the positive index of Ki-67 <10%. In situ MCL can be seen in pathology examination. IgVH gene mutation positive and SOX11 negative expression are notable in indolent MCL. International prognostic index of MCL is probably not appropriate in the prognostic analysis of leukemic indolent MCL. It is emphasized that initial observation and having therapies only after the disease progression can be suited for indolent MCL.
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Objective@#To investigate the expression levels of S100A6, Notch1 in multiple myeloma (MM) patients and its clinical significance.@*Mathods@#The expression levels of S100A6, Notch1 in 28 MM cases and 20 healthy controls were determined by real time quantitative PCR (RQ-PCR) , and their relationships with clinical features and outcomes were analyzed. Immunohistochemical was used to analysis the levels of S100A6 and Notch1 in bone marrow biopsy samples and intramedullary metastases soft tissues. RQ-PCR and Western blot were used to test the changes of Notch1 mRNA and Notch1 protein in U266 MM cells after S100A6 silenced by siRNA.@*Results@#①The expression levels of S100A6, Notch1 in primary MM patients was 2.19±1.25, 2.98±0.64, significantly higher than those in controls (0.71±0.20, 0.58±0.39, P<0.05) and patients in platform status (0.85±0.26, 0.72±0.40, P<0.05) . 8 cases with intramedullary metastasis had significantly higher levels of S100A6 (3.36±1.23) and Notch1 (5.71±3.96) , as compared to those without extra medullary metastases. ②S100A6 expression was positive correlation with Notch1 (r=0.505, P=0.007) . ③S100A6 and Notch1 proteins were positive in plasma cells of bone marrow biopsy samples and intramedullary metastases soft tissues. ④The Notch1 mRNA and Notch1 expression decreased significantly after 48 hours treatment by S100A6 siRNA in U266 cells.@*Conclusion@#S100A6 and Notch1 were closely associated with MM progress and intramedullary metastasis. They have significant correlation and might be as two prognostic molecular markers in MM.
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Objective: To investigate the expressions of S100A6, annexin A2 (AnxA2) and c-myc in patients with multiple myeloma (MM) and their clinical significance. Methods: The expressions of S100A6, AnxA2 and c-myc mRNAs in bone marrow mononuclear cells from 28 cases of MM before and after chemotherapy and 20 controls (whose peripheral blood white cell count and the platelet count were a little lower than the normal values, but the result of bone marrow aspiration was normal) were detected by real-time fluorescent quantitative PCR. The relationships among the expressions of S100A6, AnxA2 and c-myc mRNAs were analyzed. The expressions of S100A6, AnxA2 and c-myc mRNAs and proteins in MM U266 cells after transfection with S100A6 siRNA were detected by real-time fluorescent quantitative PCR and Western blotting, respectively. Results: The expression levels of S100A6, AnxA2 and c-myc mRNAs in bone marrow mononuclear cells from patients with MM were higher than those from the controls (all P < 0.05). The expression levels of S100A6, AnxA2 and c-myc mRNAs in bone marrow mononuclear cells from patients with MM before chemotherapy were higher than those after chemotherapy (all P < 0.05). The expression levels of S100A6, AnxA2 and c-myc mRNAs in bone marrow mononuclear cells from MM patients with extramedullary metastasis were higher than those from MM patients not having extramedullary metastasis (all P < 0.05). The expression of S100A6 mRNA was positively correlated with the expressions of AnxA2 and c-myc mRNAs (r = 0.585, P = 0.001; r = 0.540, P =0.004). The expression levels of S100A6, AnxA2 and c-myc mRNAs and proteins in MM U266 cells after transfection with S100A6 siRNA were down-regulated (all P < 0.05). Conclusion: The expression level of S100A6 in patients with MM is higher, and it is positively associated with AnxA2 and c-myc. S100A6 may be involved in the development, progression and extramedullary metastasis of MM.