Marker expression in peripheral T-cell lymphoma: a proposed clinical-pathologic prognostic score.
OBJECTIVE
Although peripheral T-cell lymphoma, unspecified (PTCL/U), is the most common T-cell tumor in Western countries, no study to date has been based on the application of a wide panel of markers to a large series of patients and assessed the impact of phenotype on survival. We evaluated the expression of 19 markers in 148 PTCLs/U and 45 PTCLs of the angioimmunoblastic type (AILD).


METHODS
The analysis was performed on tissue microarrays by immunohistochemistry and in situ hybridization. Clinical data were available in 93 PTCL/U patients, most of whom had been included in a previous study proposing a prognostic index (PIT).


RESULTS
An aberrant phenotype with frequent loss of CD5 and/or CD7 was typical for PTCLs, irrespective of whether they were U or AILD. Aberrantly expressed proteins rarely included CD20, CD15, and CD30. Positivity for Epstein-Barr virus-associated small RNAs and CD15 expression emerged as adverse prognostic factors. Among PTCLs/U, the proliferation-associated protein Ki-67 turned out to be prognostically relevant and was integrated in a new predictive score, incorporating age (> 60 years), high lactate dehydrogenase, poor performance status, and Ki-67 > or = 80%. This score was associated with the patient outcome (P < .0001) and was found to be more robust than PIT (P = .0043) in the present series.


CONCLUSIONS
Our retrospective analysis shows a wide range of protein expression in PTCLs and proposes a new prognostic index. The latter represents one of the first examples of mixed score (including patient- and tumor-specific factors) applied to malignant lymphomas and may be the basis for future prospective therapeutic trials.
Went
Philip
P
Institute of Hematology and Clinical Oncology L. and A. Seràgnoli, Hematology and Hematopathology Units, St Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Agostinelli
Claudio
C
Gallamini
Andrea
A
Piccaluga
Pier Paolo
PP
Ascani
Stefano
S
Sabattini
Elena
E
Bacci
Francesco
F
Falini
Brunangelo
B
Motta
Teresio
T
Paulli
Marco
M
Artusi
Tullio
T
Piccioli
Milena
M
Zinzani
Pier Luigi
PL
Pileri
Stefano A
SA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000032:analysis*; D018951:Antigens, CD20 / Q000032:analysis; D019011:Antigens, CD7 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000276:immunology; D018801:CD2 Antigens / Q000032:analysis; D017252:CD3 Complex / Q000032:analysis; D015704:CD4 Antigens / Q000032:analysis; D018956:CD5 Antigens / Q000032:analysis; D016827:CD8 Antigens / Q000032:analysis; D002986:Clinical Trials as Topic; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D017730:Ki-1 Antigen / Q000032:analysis; D019394:Ki-67 Antigen / Q000032:analysis*; D016256:Lewis X Antigen / Q000032:analysis; D016411:Lymphoma, T-Cell, Peripheral / Q000737:chemistry* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015260:Neprilysin / Q000032:analysis; D010641:Phenotype; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D046888:Tissue Array Analysis
D015703:Antigens, CD; D018951:Antigens, CD20; D019011:Antigens, CD7; D014408:Biomarkers, Tumor; D018801:CD2 Antigens; D017252:CD3 Complex; D015704:CD4 Antigens; D018956:CD5 Antigens; D016827:CD8 Antigens; D017730:Ki-1 Antigen; D019394:Ki-67 Antigen; D016256:Lewis X Antigen; D015260:Neprilysin