Prognostic significance of CD40 expression in malignant lymphoma developing in rheumatoid arthritis.
OBJECTIVE
CD40, a member of tumor necrosis factor receptor superfamily, is expressed in synovial fluid B cells in rheumatoid arthritis (RA) and is postulated to contribute to RA progression. In this study, prognostic significance of CD40 expression was analyzed in B cell lymphoproliferative disorders (LPD) developing in RA.


METHODS
CD40 expression was immunohistochemically examined in 35 cases of B-cell LPD developing in RA and in 32 of sporadic B-cell LPD as control. CD40 expression at mRNA level evaluated by quantitative reverse transcription-PCR and at protein level evaluated by immunohistochemistry correlated.


RESULTS
Frequency of diffuse large B-cell lymphoma (DLBCL) in RA- and sporadic-LPD was 71.4 and 59.3%, respectively. CD40 positive rate in RA-LPD (62.9%) was significantly higher than that in sporadic LPD (37.5%) (P = 0.015). Interval between onset of RA and LPD development was shorter in CD40 positive cases than in negative cases (median 120 and 204 months, respectively) (P < 0.07). Five-year survival rate in CD40 positive DLBCL cases (75%) was significantly better than that in negative cases (25%) (P < 0.05).


CONCLUSIONS
RA-LPD is characterized by the higher frequency of CD40 expression compared to sporadic LPD and CD40 positive cases which showed more favorable prognosis than those without CD40 expression.
Sasaki
Toru
T
Department of Pathology (C3), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Hoshida
Yoshihiko
Y
Xu
Jian-Xian
JX
Tomita
Yasuhiko
Y
Sakane-Ishikawa
Emi
E
Fujita
Shigeki
S
Aozasa
Katsuyuki
K
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001402:B-Lymphocytes / Q000276:immunology*; D014408:Biomarkers, Tumor / Q000032:analysis*; D019013:CD40 Antigens / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008223:Lymphoma / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D013582:Synovial Fluid / Q000166:cytology / Q000276:immunology*
D014408:Biomarkers, Tumor; D019013:CD40 Antigens