title: Incidence of diffuse large B-cell lymphoma of germinal center B-cell origin in whole diffuse large B-cell lymphoma: tissue fluorescence in situ hybridization using t(14;18) compared with immunohistochemistry.
abstract: Diffuse large B-cell lymphoma (DLBCL) can be divided into prognostically important categories such as germinal center B (GCB)-like and non-GCB-like groups. The t(14;18)(q32;q21) translocation defines a unique subset of DLBCL cases with a GCB gene expression profile. Two-color fluorescence in situ hybridization (FISH) analysis was applied to detect t(14;18) (q32;q21) in the nuclei of paraffin-embedded tissue sections from 61 patients with de novo DLBCL. Nine (15%) of 61 cases had a positive pattern. Fifty-seven cases were subclassified in an immunohistochemical study with anti-CD10, anti-bcl-6, and anti-MUM1 antibodies. In this classification, 21 cases (37%) were placed in the GCB group, and 36 (63%) were placed in the non-GCB group. There was a discrepancy between t(14;18) occurrence and bcl-2 protein expression. Bcl-2 protein expression was positive in 40 (67%) of 60 cases. The expression of bcl-2 protein in the GCB and non-GCB groups was not significantly different: 15 (71%) of 21 cases in the GCB group and 24 (67%) of 36 cases in the non-GCB group tested positive. We found no difference between the FISH-positive and FISH-negative groups in overall survival time (P = .6019, log-rank test). The overall survival rates of GCB and non-GCB groups did not differ significantly by immunohistochemical classification (P = .5399, log-rank test). Overall survival was significantly longer in the group with a low International Prognostic Index (IPI) score than in the group with a high IPI score (P = .0002, log-rank test). Our results suggest that immunohistochemical study and cytogenetic study with t(14;18) FISH cannot predict the clinical outcomes of DLBCL patients. A study with a larger number of patients may show a difference in clinical outcomes between FISH-positive and FISH-negative groups and between GCB and non-GCB groups.
authors.affiliation: Department of Hematology and Immunology, Kanazawa Medical University, Ishikawa, Japan. y-hirose@kanazawa-med.ac.jp
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hirose
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Masaki
authors.forename: Hiromi
authors.initials: H
authors.lastname: Karasawa
authors.forename: Kumiko
authors.initials: K
authors.lastname: Shimoyama
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fukushima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawabata
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Ogawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Wano
authors.forename: Mamoru
authors.initials: M
authors.lastname: Ozaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002883:Chromosomes, Human, Pair 14; D002887:Chromosomes, Human, Pair 18; D005260:Female; D018858:Germinal Center / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D015994:Incidence; D016393:Lymphoma, B-Cell / Q000235:genetics / Q000401:mortality / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014178:Translocation, Genetic
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