Liu Jing, Wang Yaming, Liu Yuantao, Liu Zhe, Cui Qu, Ji Nan, Sun Shengjun, Wang Bingxu, Wang Yajie, Sun Xuefei, Liu Yuanbo
Department of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.
Department of Neurosurgery, Navy General Hospital, Beijing 100050, P.R. China.
Oncol Lett. 2017 Nov;14(5):5505-5512. doi: 10.3892/ol.2017.6893. Epub 2017 Sep 6.
The majority of primary central nervous system lymphomas (PCNSLs) are diffuse large B cell lymphoma, characterized by poor prognosis. In the present study, the expression of cluster of differentiation (CD)10, B cell lymphoma (BCL)-6, multiple myeloma-1 (MUM-1), BCL-2, CD138 and Ki-67 was analyzed by immunohistochemistry in 89 Chinese PCNSL cases, and the potential prognostic significance was evaluated. CD10, BCL-6, MUM-1, BCL-2 and CD138 were positive in 16.9 (15/89), 51.7 (46/89), 92.1 (82/89), 73.3 (63/86) and 0% (0/65) of all cases, respectively. According to the Hans algorithm, 71 patients (79.8%) were classified into the non-germinal center B cell-like (non-GCB) group, indicating a post-germinal center origin of PCNSL. The median follow-up time of 73 patients was 13 months [95% confidence interval (CI), 10.93-15.08]. The median overall survival (OS) time was 45.3 months (95% CI, 25.01-65.59) and the median progression-free survival (PFS) time was 30.0 months (95% CI, 13.43-46.57). Age (>60 years) was associated with a shorter OS time (P=0.009). Ki-67 (cutoff point 90%) was associated with shorter OS (P=0.037) and shorter PFS (P=0.039) times. No other immunohistochemical markers were associated with prognosis. On multivariate analysis, age (>60 years) was associated with shorter OS time (P=0.038), but immunophenotype and expression status of Ki-67, CD10, BCL-6 and BCL-2 did not predict prognosis. In conclusion, high Ki-67 expression may predict poor prognosis in PCNSL. The present study was limited by its sample size and short follow-up time. This requires more evidence to further clinical study.
大多数原发性中枢神经系统淋巴瘤（PCNSL）为弥漫性大B细胞淋巴瘤，预后较差。在本研究中，采用免疫组织化学方法分析了89例中国PCNSL患者中分化簇（CD）10、B细胞淋巴瘤（BCL）-6、多发性骨髓瘤-1（MUM-1）、BCL-2、CD138和Ki-67的表达情况，并评估其潜在的预后意义。所有病例中，CD10、BCL-6、MUM-1、BCL-2和CD138阳性率分别为16.9%（15/89）、51.7%（46/89）、92.1%（82/89）、73.3%（63/86）和0%（0/65）。根据汉斯算法，71例患者（79.8%）被归类为非生发中心B细胞样（non-GCB）组，提示PCNSL起源于生发中心后阶段。73例患者的中位随访时间为13个月[95%置信区间（CI），10.93 - 15.08]。中位总生存期（OS）为45.3个月（95%CI，25.01 - 65.59），中位无进展生存期（PFS）为30.0个月（95%CI，13.43 - 46.57）。年龄（>60岁）与较短的OS时间相关（P = 0.009）。Ki-67（临界值90%）与较短的OS（P = 0.037）和较短的PFS（P = 0.039）时间相关。其他免疫组化标志物与预后均无关联。多因素分析显示，年龄（>60岁）与较短的OS时间相关（P = 0.038），但免疫表型及Ki-67、CD10、BCL-6和BCL-2的表达状态均不能预测预后。总之，Ki-67高表达可能提示PCNSL预后不良。本研究受样本量和随访时间短的限制。这需要更多证据以进一步开展临床研究。
