Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Hum Pathol. 2021 Feb;108:22-31. doi: 10.1016/j.humpath.2020.11.002. Epub 2020 Nov 19.
The role of MYC dysregulation has been studied extensively in B-cell lymphomas, but little is known about its significance in T cell lymphomas. This study, for the first time in the literature, assessed the clinicopathologic and prognostic significance of MYC expression in ALK+ anaplastic large cell lymphoma (ALCL) cases. Using ≥50% as the cutoff value for positive MYC expression by immunohistochemistry, 17 of 46 (37%) cases were MYC+. Patients with MYC+ tumors were older (median age, 39 versus 29 years, p = 0.04) and more often showed a common morphologic pattern (100% versus 69%, p = 0.02), when compared with those with MYC-negative tumors. By fluorescence in situ hybridization analysis, 9 of 31 (29%) cases showed increased MYC copy number, and 1 of 31 (3%) case had an MYC rearrangement, and the remaining 21 (68%) cases showed no MYC aberrations. Among the cases with increased MYC copy number, 5 of 8 (62%) cases showed MYC copy gain and/or amplification and 3 of 8 (38%) had polysomy 8. MYC expression was associated with increased MYC copy number (p = 0.01). MYC expression, but not increased MYC copy number, correlated with shorter overall survival (OS) (p = 0.03). In conclusion, MYC expression identified a distinct group of ALK + ALCL patients with more aggressive behavior and shorter OS. Our data suggest that MYC expression is an adverse prognostic factor and may be useful in stratifying or predicting the prognosis of patients with ALK+ ALCL.
MYC 失调的作用在 B 细胞淋巴瘤中已被广泛研究，但在 T 细胞淋巴瘤中其意义知之甚少。本研究首次评估了 MYC 表达在间变性大细胞淋巴瘤（ALCL）中的临床病理和预后意义。通过免疫组化检测，以≥50%为阳性 MYC 表达的截断值，46 例病例中有 17 例（37%）为 MYC+。与 MYC 阴性肿瘤相比，MYC+肿瘤患者年龄较大（中位数年龄 39 岁 vs 29 岁，p=0.04）且更常表现为常见形态学模式（100% vs 69%，p=0.02）。通过荧光原位杂交分析，31 例中有 9 例（29%）显示 MYC 拷贝数增加，1 例（3%）有 MYC 重排，其余 21 例（68%）无 MYC 异常。在 MYC 拷贝数增加的病例中，8 例中有 5 例（62%）显示 MYC 拷贝数增益和/或扩增，8 例中有 3 例（38%）存在 8 号染色体三体。MYC 表达与增加的 MYC 拷贝数相关（p=0.01）。MYC 表达而不是增加的 MYC 拷贝数与总生存（OS）较短相关（p=0.03）。总之，MYC 表达确定了一组具有更具侵袭性行为和更短 OS 的独特 ALK+ALCL 患者。我们的数据表明，MYC 表达是一个不良预后因素，可能有助于对 ALK+ALCL 患者进行分层或预测预后。
