Fan Y, Dong L, OUYang B S, Xu H M, Zheng S F, Wang A R, Wang C F
Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025,China.
Zhonghua Bing Li Xue Za Zhi. 2020 May 8;49(5):448-453. doi: 10.3760/cma.j.cn112151-20190820-00458.
To investigate the relationship between the protein expression of C-MYC, bcl-2 and bcl-6 and the clinicopathological characteristics in patients with de novo CD5-positive diffuse large B cell lymphoma (CD5(+)DLBCL). Fifty seven cases of de novo CD5(+)DLBCL were collected at Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from February 2013 to September 2018. The hematoxylin-eosin stained slides were reviewed, and immunohistochemical (IHC) staining and FISH were used to analyze the relationship between C-MYC, bcl-2, bcl-6 expression and the clinicopathologic characteristics of patients. Among these 57 cases, 27 were male and 30 were female. The age of onset was 35-99 years old. The IHC expression rates of C-MYC, bcl-2 and bcl-6 were 50.9% (29/57), 84.2% (48/57), and 75.4% (43/57) respectively; and co-expression rate of C-MYC and bcl-2 proteins was 40.4 (23/57). There was no significant correlation between protein expression and patients' genders, clinical stage, the level of serum LDH,β2 microglobulin, IPI,B symptoms, bone marrow involvement and central nervous system recurrence (0.05). Univariate analysis showed that the median OS of C-MYC negative patients was significantly longer than C-MYC positive patients (0.05); and the median OS of patients without double expression was significantly longer than that of patients with positive expression (0.05), and bcl-6 positive patients had longer median OS than bcl-6 negative patients (0.05). There was no significant correlation between prognosis and bcl-2 protein expression (0.05) . Cox multivariate analysis showed C-MYC protein expression was an independent predictor of OS in de novo CD5(+)DLBCL (0.05). Bcl-2 protein expression has no effect on the prognosis in de novo CD5(+)DLBCL whereas bcl-6 expression is correlated with good prognosis. C-MYC protein expression could be used as an independent and effective index to predict the prognosis of patients with de novo CD5(+)DLBCL.However, the relationship between protein expression and gene rearrangement of C-MYC, bcl-2 and bcl-6 needs to be further explored.
探讨初治CD5阳性弥漫性大B细胞淋巴瘤(CD5(+)DLBCL)患者中C-MYC、bcl-2和bcl-6蛋白表达与临床病理特征之间的关系。2013年2月至2018年9月期间,收集上海交通大学医学院附属瑞金医院57例初治CD5(+)DLBCL患者。复查苏木精-伊红染色切片,采用免疫组织化学(IHC)染色和荧光原位杂交(FISH)分析C-MYC、bcl-2、bcl-6表达与患者临床病理特征之间的关系。这57例患者中,男性27例,女性30例。发病年龄为35-99岁。C-MYC、bcl-2和bcl-6的IHC表达率分别为50.9%(29/57)、84.2%(48/57)和75.4%(43/57);C-MYC和bcl-2蛋白的共表达率为40.4%(23/57)。蛋白表达与患者性别、临床分期、血清乳酸脱氢酶水平、β2微球蛋白、国际预后指数(IPI)、B症状、骨髓受累及中枢神经系统复发之间无显著相关性(P>0.05)。单因素分析显示,C-MYC阴性患者的中位总生存期(OS)显著长于C-MYC阳性患者(P<0.05);无双重表达患者的中位OS显著长于有阳性表达患者(P<0.05),且bcl-6阳性患者的中位OS长于bcl-6阴性患者(P<0.05)。预后与bcl-2蛋白表达无显著相关性(P>0.05)。Cox多因素分析显示,C-MYC蛋白表达是初治CD5(+)DLBCL患者OS的独立预测因素(P<0.05)。bcl-2蛋白表达对初治CD5(+)DLBCL患者的预后无影响,而bcl-6表达与良好预后相关。C-MYC蛋白表达可作为预测初治CD5(+)DLBCL患者预后的独立有效指标。然而,C-MYC、bcl-2和bcl-6蛋白表达与基因重排之间的关系尚需进一步探索。