Objective: To investigate the histological features and prognostic factors of angioimmunoblastic T-cell lymphoma (AITL). Methods: The pathological data of 62 patients with AITL with complete follow-up information were retrospectively collected and analyzed from Changhai Hospital during September 2012 and September 2017. Histological and immunohistochemical (IHC) examination, in situ hybridization (ISH), and single nucleotide polymorphisms (SNP) gene mutation analysis were done. Subgroup evaluation with histology, IHC, ISH, SNP gene mutation, and association with clinical progression were performed. Results: The cohort included 62 cases of AITL, including 46 males and 16 females patients, with a median age of 64 years. Follicular dendritic cells (FDC) area showed significantly expansion (≥30%) in 40 cases; increased plasma cells (≥10%) was seen in 37 cases; B cells were distributed around blood vessels in 37 cases; and increased p53 mutation positive cells (≥40%) were seen in 39 cases; high Ki-67 index (≥40%) was seen in 39 cases; RHOA mutation was seen in 19 cases; TET2 mutation was seen in 9 cases. Overall survival analysis showed these factors were significantly correlated with tumor prognosis (P<0.05). Multivariate analysis showed that CD38 positive cells<10%, Ki-67≥40%, RHOA and TET2 mutations were risk factors associated with overall survival. Conclusions: AITL could be divided into two different prognostic groups, low-grade and high-grade, with statistically significance outcome, based on the FDC area expansion, degree of plasma cell proliferation, B cells distribution pattern combined with gene mutations and clinical progression. Low-grade malignant group progresses slowly, and high-grade malignant group is highly invasive.
目的： 探讨血管免疫母细胞性T细胞淋巴瘤（AITL）的组织学分级及预后相关因素。 方法： 对海军军医大学附属长海医院2012年9月至2017年9月已确诊并有完整随访资料的62例AITL患者病理资料进行回顾性分析，通过形态学观察、免疫组织化学、原位杂交、基因突变检测等实验方法进行一系列分组评估，分析其与临床病程进展的相关性。 结果： 62例AITL病例，男性46例，女性16例，中位年龄64岁。滤泡树突细胞（FDC）网面积明显扩展（≥30%）40例，浆细胞显著增生（≥10%）37例，B细胞围绕血管聚集分布37例，p53高表达（≥40%）39例，Ki-67阳性指数增高（≥40%）39例，基因检测RHOA突变19例，TET2突变9例，单因素生存分析显示以上各因素均与预后有明显相关性（均P<0.05）。多因素分析提示CD38阳性细胞<10%、Ki-67阳性指数≥40%、RHOA及TET2突变是影响预后的危险因素。 结论： 根据AITL中FDC网扩展面积、浆细胞增生程度、B细胞分布模式，并结合基因突变可将AITL分为低度恶性组和高度恶性组，低度恶性组进展缓慢，高度恶性组呈高度侵袭。.
Keywords: Genetics; Lymphoma, T-cell; Morphology; Prognosis.