Departments of Hematopathology.
Department of Pathology, Henan Provincial Hospital, Zhengzhou, Henan.
Am J Surg Pathol. 2019 May;43(5):710-716. doi: 10.1097/PAS.0000000000001233.
Studies have suggested that SOX11 expression has prognostic implications in patients with mantle cell lymphoma (MCL), but the data are controversial. In this study, we describe the clinicopathologic and prognostic features of 75 patients with SOX11-negative MCL. Compared with patients with SOX11-positive MCL, SOX11-negative MCL patients more frequently had leukemic non-nodal disease (21% vs. 4%, P=0.0001). SOX11-negative MCLs more often showed classic morphology (83% vs. 65%, P=0.005), were more often positive for CD23 (39% vs. 22%, P=0.02) and CD200 (60% vs. 9%, P=0.0001), and had a lower proliferation index (Ki67 23% vs. 33%, P=0.04). Overall survival (OS) was not significantly different between patients with SOX11-negative versus SOX11-positive MCL (P=0.63). High Ki67 index and blastoid/pleomorphic morphology were associated with shorter OS in both SOX11-negative (P<0.05) and SOX11-positive MCL groups (P<0.05). A high Mantle Cell Lymphoma International Prognostic Index (MIPI) predicted poorer prognosis in patients with SOX11-negative MCL (P<0.0001), but not SOX11-positive MCL (P=0.09). Nodal involvement and stage III/IV disease were associated with poorer outcome in patients with SOX11-positive MCL (P=0.03 and 0.04, respectively), but not SOX11-negative MCL (P=0.88 and 0.74, respectively). In summary, SOX11-negative MCL is characterized by more frequent leukemic non-nodal disease, classic morphology, more frequent expression of CD23 and CD200, and a lower Ki67 index. Prognostic factors in patients with SOX11-negative MCL include morphology, Ki67 index, and MIPI score.
研究表明，SOX11 表达对套细胞淋巴瘤（MCL）患者具有预后意义，但数据存在争议。在这项研究中，我们描述了 75 例 SOX11 阴性 MCL 患者的临床病理和预后特征。与 SOX11 阳性 MCL 患者相比，SOX11 阴性 MCL 患者更常发生白血病性非结外疾病（21% vs. 4%，P=0.0001）。SOX11 阴性 MCL 更常表现为经典形态（83% vs. 65%，P=0.005），更常表达 CD23（39% vs. 22%，P=0.02）和 CD200（60% vs. 9%，P=0.0001），且增殖指数较低（Ki67 为 23% vs. 33%，P=0.04）。SOX11 阴性与 SOX11 阳性 MCL 患者的总生存（OS）无显著差异（P=0.63）。高 Ki67 指数和母细胞样/多形性形态与 SOX11 阴性（P<0.05）和 SOX11 阳性 MCL 组（P<0.05）的 OS 较短相关。高套细胞淋巴瘤国际预后指数（MIPI）预测 SOX11 阴性 MCL 患者预后不良（P<0.0001），但对 SOX11 阳性 MCL 患者无影响（P=0.09）。淋巴结受累和 III/IV 期疾病与 SOX11 阳性 MCL 患者的不良预后相关（P=0.03 和 0.04），但与 SOX11 阴性 MCL 患者无相关性（P=0.88 和 0.74）。总之，SOX11 阴性 MCL 的特点是更频繁的白血病性非结外疾病、经典形态、更频繁表达 CD23 和 CD200 以及较低的 Ki67 指数。SOX11 阴性 MCL 患者的预后因素包括形态、Ki67 指数和 MIPI 评分。
