Zhang Hong-wei, Chen Zhen-wen, He Jian-xia, Zheng Yu-ping, Han Wei-e, Zhao Zhi-qiang, Bai Wei, Wang Jin-fen
Department of Hematology, Shanxi Tumor Hospital, Taiyuan, China.
Zhonghua Zhong Liu Za Zhi. 2013 Feb;35(2):119-23. doi: 10.3760/cma.j.issn.0253-3766.2013.02.009.
To study the relationship between myc gene rearrangement and myc protein expression in diffuse large B cell lymphoma (DLBCL), and their correlation with prognosis.
One hundred and six cases of DLBCLs with follow-up data were analyzed using interphase fluorescence in situ hybridization (FISH) technique. Immunophenotyping analysis for CD20, CD3, myc, Mum-1, CD10, bcl-6 was also performed using EnVision immunohistochemistry.
The percentages of tumor cells expressing myc, Mum-1, CD10 and bcl-6 were 70.8%, 56.6%, 21.7% and 26.4%, respectively. Twenty six cases (24.5%) were of GCB type and the rest (75.5%) were of non-GCB (non germinal center) type. The myc rearrangement was identified in 13 (12.3%) of 106 cases. 13 cases showed to be of non-GCB type. There was no correlation between myc rearrangement and myc protein expression. DLBCLs (n = 13) with myc rearrangement showed significantly poorer overall survival (OS) and progression free survival (PFS), with a median OS and PFS time of 4.7 and 3.2 months, respectively (for OS and PFS, P < 0.001). Multivariate analysis using Cox proportional hazard model confirmed that myc rearrangement, ECOG performance status of 2-4, immunophenotyping subgroup and myc protein were independent factors affecting the prognosis and significantly associated with the survival. However, myc rearrangement was the strongest prognostic factor.
DLBCL with myc gene rearrangement is a subgroup of non-GCB DLBCL with poor outcome. It is an independent and useful factor for prognosis in DLBCL. Expression of myc is influenced by many factors and myc rearrangement may be one of these factors.
研究弥漫性大B细胞淋巴瘤（DLBCL）中myc基因重排与myc蛋白表达之间的关系，以及它们与预后的相关性。
采用间期荧光原位杂交（FISH）技术分析106例有随访数据的DLBCL病例。同时使用EnVision免疫组织化学法对CD20、CD3、myc、Mum-1、CD10、bcl-6进行免疫表型分析。
表达myc、Mum-1、CD10和bcl-6的肿瘤细胞百分比分别为70.8%、56.6%、21.7%和26.4%。26例（24.5%）为生发中心B细胞（GCB）型，其余（75.5%）为非GCB（非生发中心）型。106例中有13例（12.3%）检测到myc基因重排。13例均为非GCB型。myc基因重排与myc蛋白表达之间无相关性。有myc基因重排的DLBCL（n = 13）患者的总生存期（OS）和无进展生存期（PFS）明显较差，OS和PFS的中位时间分别为4.7个月和3.2个月（OS和PFS，P < 0.001）。使用Cox比例风险模型进行多因素分析证实，myc基因重排、东部肿瘤协作组（ECOG）体能状态为2 - 4、免疫表型亚组和myc蛋白是影响预后的独立因素，且与生存显著相关。然而，myc基因重排是最强的预后因素。
伴有myc基因重排的DLBCL是非GCB型DLBCL的一个预后不良亚组。它是DLBCL预后的一个独立且有用的因素。myc的表达受多种因素影响，myc基因重排可能是其中之一。
