Department of Neurosurgery, Kumamoto University, 1-1-1 Honjo Chuo-ku, Kumamoto, 860-8556, Japan.
Department of Diagnostic Pathology, Kumamoto University Hospital, 1-1-1 Honjo Chuo-ku, Kumamoto, 860-8556, Japan.
J Neurooncol. 2018 Oct;140(1):115-121. doi: 10.1007/s11060-018-2940-3. Epub 2018 Jul 2.
Primary central nervous system diffuse large B-cell lymphoma (CNS-DLBCL) is a distinct clinicopathological entity with a poor prognosis. Concurrent MYC and BCL2 overexpression predicts inferior prognosis in systemic DLBCL, although their prognostic significance remains unclear in primary CNS-DLBCL.
Pretreatment diagnostic biopsy samples were retrospectively evaluated for 79 patients with primary CNS-DLBCL who were treated between January 2001 and December 2017. Histological and immunohistochemical testing were performed to evaluate the patients' statuses for various markers, which were also evaluated for associations with survival outcomes.
According to the Hans criteria, 26 patients (32.9%) had the germinal center B-cell subtype and 53 patients (67.1%) had the activated B-cell subtype. Forty-one cases (51.9%) were positive for MYC (expression of ≥ 40%), 33 cases (41.8%) were positive for BCL2 (expression of ≥ 70%), 22 patients (27.8%) were positive for both MYC and BCL2, and 27 patients (34.2%) were negative for both MYC and BCL2. There were no significant differences in survival between the germinal center and activated B-cell subtypes. Furthermore, MYC positivity was not associated with overall survival (p = 0.369) or progression-free survival (PFS) (p = 0.253). However, BCL2 positivity was significantly associated with poor overall survival (p = 0.039) and PFS (p = 0.036). Co-expression of MYC and BCL2 was not associated with survival.
Our data suggest that evaluating BCL2 expression may help predict the prognosis in cases of primary CNS-DLBCL.
原发性中枢神经系统弥漫性大 B 细胞淋巴瘤（CNS-DLBCL）是一种具有不良预后的独特临床病理实体。MYC 和 BCL2 的同时过表达预示着系统性 DLBCL 的预后不良，尽管它们在原发性 CNS-DLBCL 中的预后意义仍不清楚。
回顾性评估了 79 例原发性 CNS-DLBCL 患者的预处理诊断性活检样本，这些患者均于 2001 年 1 月至 2017 年 12 月接受治疗。进行了组织学和免疫组织化学检测，以评估患者的各种标志物状态，并评估其与生存结局的相关性。
根据 Hans 标准，26 例（32.9%）患者为生发中心 B 细胞亚型，53 例（67.1%）患者为活化 B 细胞亚型。41 例（51.9%）病例 MYC 阳性（表达≥40%），33 例（41.8%）BCL2 阳性（表达≥70%），22 例（27.8%）同时 MYC 和 BCL2 阳性，27 例（34.2%）同时 MYC 和 BCL2 阴性。生发中心和活化 B 细胞亚型之间的生存无显著差异。此外，MYC 阳性与总生存（p=0.369）或无进展生存（PFS）（p=0.253）无关。然而，BCL2 阳性与总生存（p=0.039）和 PFS（p=0.036）差显著相关。MYC 和 BCL2 的共表达与生存无关。
我们的数据表明，评估 BCL2 表达可能有助于预测原发性 CNS-DLBCL 的预后。
