Zaiem Feras, Jerbi Rada, Albanyan Omar, Puccio Jordyn, Kafri Zyad, Yang Jay, Gabali Ali M
Hematopathology department, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, Michigan, USA.
Pathology Department, Christ Hospital, Cincinnati, Ohio, USA.
Avicenna J Med. 2020 Oct 13;10(4):241-248. doi: 10.4103/ajm.ajm_81_20. eCollection 2020 Oct-Dec.
CD10, BCL6, and MUM1 are commonly used immunohistochemical stains for classifying diffuse large B-cell lymphoma (DLBCL), which is useful in predicting outcome. Conflicting reports of the prognostic value of other markers such as BCL2, CD23, and Ki67 proliferation index have been reported. Our objective was to correlate these immunostains and Hans classification with response to therapy and overall survival.
A retrospective study of patients diagnosed with DLBCL from 2008-2014 at a tertiary-care cancer hospital. The slides with the IHC stains were reviewed by two independent pathologists. The clinical outcomes--assessed independently--were response to therapy and overall survival. The treatment response evaluation was based on the new Lugano classification. Statistical analyses were conducted using the Fisher's exact test and Kaplan-Meier survival curves. Significance was set at < 0.05.
Forty-one patients were included in the study with a known Hans classification, available clinical data, and at least 5-year follow-up. CD10 immunostain was reported in all patients, whereas CD23 was the least reported in only four patients. No significant association was observed between CD10, BCL6, MUM1, BCL2, and both Response to therapy and overall survival. Owing to few cases reported CD23 immunostain, further analysis of association is not reported. High Ki67 proliferative index of >80% was statistically significantly associated with shorter overall survival and not statistically significant associated with no response to therapy. Hans classification subtypes were not predictive in regard to therapy response.
High Ki67 expression (>80%) was associated with shorter overall survival in DLBCL. Hans classification subtypes were not predictive.
CD10、BCL6和MUM1是常用于弥漫性大B细胞淋巴瘤（DLBCL）分类的免疫组化染色，这有助于预测预后。关于其他标志物如BCL2、CD23和Ki67增殖指数的预后价值，已有相互矛盾的报道。我们的目的是将这些免疫染色和汉斯分类与治疗反应及总生存期相关联。
对2008年至2014年在一家三级癌症专科医院诊断为DLBCL的患者进行回顾性研究。两位独立病理学家对免疫组化染色切片进行复查。独立评估的临床结局为治疗反应和总生存期。治疗反应评估基于新的卢加诺分类。采用Fisher精确检验和Kaplan-Meier生存曲线进行统计分析。显著性设定为<0.05。
41例患者纳入研究，已知汉斯分类、有可用临床数据且至少随访5年。所有患者均报告了CD10免疫染色，而CD23仅在4例患者中最少报告。未观察到CD10、BCL6、MUM1、BCL2与治疗反应及总生存期之间存在显著关联。由于报告CD23免疫染色的病例较少，未报告进一步的关联分析。Ki67增殖指数>80%与较短的总生存期在统计学上显著相关，与治疗无反应在统计学上无显著关联。汉斯分类亚型对治疗反应无预测性。
在DLBCL中，高Ki67表达（>80%）与较短的总生存期相关。汉斯分类亚型无预测性。
