Nuclear expression of BCL10 or nuclear factor kappa B predicts Helicobacter pylori-independent status of early-stage, high-grade gastric mucosa-associated lymphoid tissue lymphomas.
OBJECTIVE
A high percentage of early-stage, high-grade gastric mucosa-associated lymphoid tissue (MALT) lymphomas remain Helicobacter pylori dependent. t(11;18)(q21;q21), a genetic aberration highly predictive of H. pylori-independent status in low-grade gastric MALT lymphoma, is rarely detected in its high-grade counterpart. This study examined whether nuclear expression of BCL10 or nuclear factor kappa B (NF-kappaB) is useful in predicting H. pylori-independent status in patients with stage IE high-grade gastric MALT lymphomas.


METHODS
Twenty-two patients who had participated in a prospective study of H. pylori eradication for stage IE high-grade gastric MALT lymphomas were studied. The expression of BCL10 and NF-kappaB in pretreatment paraffin-embedded lymphoma tissues was evaluated by immunohistochemistry and confocal immunofluorescence microscopy. The presence of t(11;18)(q21;q21) was identified by a multiplex reverse transcriptase polymerase chain reaction of the API2-MALT1 chimeric transcript.


RESULTS
Aberrant nuclear expression of BCL10 was detected in seven (87.5%) of eight H. pylori-independent and in none of 14 H. pylori-dependent high-grade gastric MALT lymphomas (P <.001). All seven patients with nuclear BCL10 expression had nuclear expression of NF-kappaB, compared with only two of 15 patients without nuclear BCL10 expression (P =.002). As a single variable, the frequency of nuclear expression of NF-kappaB was also significantly higher in H. pylori-independent tumors than in H. pylori-dependent tumors (seven of eight [87.5%] v two of 15 [12.3%]; P =.002). The API2-MALT1 fusion transcript was detected in only one (12.5%) of eight H. pylori-independent lymphomas.


CONCLUSIONS
Nuclear expression of BCL10 or NF-kappaB is highly predictive of H. pylori-independent status in high-grade gastric MALT lymphoma, and coexpression of these two markers in the nuclei is frequent.
Kuo
Sung-Hsin
SH
Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medidine, Taipei, Taiwan.
Chen
Li-Tzong
LT
Yeh
Kun-Huei
KH
Wu
Ming-Shiang
MS
Hsu
Hui-Chen
HC
Yeh
Pei-Yen
PY
Mao
Tsui-Lien
TL
Chen
Chi-Long
CL
Doong
Shin-Lian
SL
Lin
Jaw-Town
JT
Cheng
Ann-Lii
AL
D048868:Adaptor Proteins, Signal Transducing; D000328:Adult; D000368:Aged; D000074018:B-Cell CLL-Lymphoma 10 Protein; D015415:Biomarkers / Q000032:analysis; D005260:Female; D016480:Helicobacter pylori; D006801:Humans; D007150:Immunohistochemistry; D018442:Lymphoma, B-Cell, Marginal Zone / Q000378:metabolism* / Q000821:virology; D008228:Lymphoma, Non-Hodgkin / Q000378:metabolism* / Q000821:virology; D008297:Male; D008875:Middle Aged; D016328:NF-kappa B / Q000378:metabolism*; D009363:Neoplasm Proteins / Q000378:metabolism*; D011446:Prospective Studies; D014178:Translocation, Genetic
D048868:Adaptor Proteins, Signal Transducing; D000074018:B-Cell CLL-Lymphoma 10 Protein; C118591:BCL10 protein, human; D015415:Biomarkers; D016328:NF-kappa B; D009363:Neoplasm Proteins