Department of Hematology, Huashan Hospital, Fudan University, 200040 Shanghai, China.
Med Oncol. 2011 Mar;28(1):241-8. doi: 10.1007/s12032-010-9433-3. Epub 2010 Feb 18.
Diffuse large B-cell lymphoma (DLBCL) has been classified into different prognostic subgroups using immunohistochemistry in Western populations. However, the applicability in Chinese patients of these subgroups was unclear. We collected 116 specimens and performed immunohistochemical staining for CD10, BCL-6, MUM1, CD138, and CD5, and the results were classified into subgroups according to 3 different algorithms. We then analyzed the subgroups' correlation to patient survival. Expression of CD10 and BCL-6 predicted favorable 5-year OS (70 and 62.5%, respectively) and PFS (64.3 and 61.5%, respectively) rates. In contrast, the expression of MUM1 predicted unfavorable 5-year OS (23.1%) and PFS (17.9%) rates and was also independent of other markers. All algorithms led to useful subclassifications. Using Hans' algorithm based on CD10, BCL-6, and MUM1, the non-germinal center (GC) subgroup (66.4%) had worse 5-year OS (29.8%) and PFS (26.7%) rates than did the GC subgroup. Likewise, using Muris' algorithm based on CD10 and MUM1, fewer non-GC cases (27%) showed poorer OS (20.3%) and PFS (16.2%) rates than did GC cases, an effect that was independent of both the International Prognostic Index, a clinical indicator, and treatment. It identified a subgroup with a high-risk of death and seemed to be applicable in our series. In conclusion, these algorithms can be used effectively in Chinese patients with DLBCL.
弥漫性大 B 细胞淋巴瘤（DLBCL）已在西方人群中通过免疫组织化学被分为不同的预后亚组。然而，这些亚组在中国患者中的适用性尚不清楚。我们收集了 116 例标本，并进行了 CD10、BCL-6、MUM1、CD138 和 CD5 的免疫组织化学染色，根据 3 种不同的算法将结果分为亚组。然后，我们分析了亚组与患者生存的相关性。CD10 和 BCL-6 的表达预测了良好的 5 年 OS（分别为 70%和 62.5%）和 PFS（分别为 64.3%和 61.5%）率。相比之下，MUM1 的表达预测了不良的 5 年 OS（23.1%）和 PFS（17.9%）率，并且与其他标志物无关。所有的算法都导致了有用的亚分类。使用基于 CD10、BCL-6 和 MUM1 的 Hans 算法，非生发中心（GC）亚组（66.4%）的 5 年 OS（29.8%）和 PFS（26.7%）率比 GC 亚组差。同样，使用基于 CD10 和 MUM1 的 Muris 算法，较少的非 GC 病例（27%）的 OS（20.3%）和 PFS（16.2%）率比 GC 病例差，这种效果独立于国际预后指数（一种临床指标）和治疗。它确定了一个死亡风险较高的亚组，似乎适用于我们的系列。总之，这些算法可有效地用于中国的 DLBCL 患者。
