Evaluation of immunophenotype in diffuse large B-cell lymphoma and its impact on prognosis.
Diffuse large B-cell lymphoma (DLBCL) has been shown to be comprised of at least two prognostic entities, depending on its resemblance to normal germinal center or activated B cells, using global gene expression profiling. Also, the expression patterns of bcl-6, CD10 and IRF-4 (also known as MUM1) have been suggested as alternative means of identifying the germinal- and nongerminal center (activated B-cell like) groups. In the present study, we evaluated by immunohistochemistry the expression patterns of CD10, bcl-6, IRF-4 and bcl-2 in a large material of 161 DLBCL patients. Using two different approaches, patients with germinal center phenotype displayed a significantly better survival than the nongerminal center group. Positive staining for bcl-6 or CD10 predicted for superior survival, while expression of IRF-4 alone showed no association with prognosis. Furthermore, expression of bcl-2 was associated with worse event-free survival and overall survival. In a multivariate analysis, a high international prognostic index score (3-5), non-GC phenotype and bcl-2 were independent adverse prognostic factors. Here we confirm the prognostic importance of determining the germinal- or nongerminal center phenotype in patients with DLBCL.
Berglund
Mattias
M
Department of Oncology, Radiology, and Clinical Immunology, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden. Mattias.Berlund@genpat.uu.se
Thunberg
Ulf
U
Amini
Rose-Marie
RM
Book
Majlis
M
Roos
Göran
G
Erlanson
Martin
M
Linderoth
Johan
J
Dictor
Michael
M
Jerkeman
Mats
M
Cavallin-Ståhl
Eva
E
Sundström
Christer
C
Rehn-Eriksson
Suzanne
S
Backlin
Carin
C
Hagberg
Hans
H
Rosenquist
Richard
R
Enblad
Gunilla
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004268:DNA-Binding Proteins / Q000032:analysis; D005260:Female; D018858:Germinal Center / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D050835:Interferon Regulatory Factors; D016393:Lymphoma, B-Cell / Q000378:metabolism / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015999:Multivariate Analysis; D015260:Neprilysin / Q000032:analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000032:analysis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D051560:Proto-Oncogene Proteins c-bcl-6; D016019:Survival Analysis; D014157:Transcription Factors / Q000032:analysis; D000099218:Interferon Regulatory Factor-4
D004268:DNA-Binding Proteins; D050835:Interferon Regulatory Factors; D015260:Neprilysin; D011518:Proto-Oncogene Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D051560:Proto-Oncogene Proteins c-bcl-6; D014157:Transcription Factors; D000099218:Interferon Regulatory Factor-4