title: Prognostic significance of T-cell or cytotoxic molecules phenotype in classical Hodgkin's lymphoma: a clinicopathologic study.
abstract: OBJECTIVE
  Classical Hodgkin's lymphoma (CHL) is characterized by Hodgkin's and Reed-Sternberg (H-RS) cells, most of which are derived from germinal-center B cells. Nevertheless, one or more markers for T cells and follicular dendritic cells (FDC) may be expressed in a minority of H-RS cells in some CHL patients, although the clinical significance of this remains controversial. The aim of this study was to clarify the association between phenotypic expression and clinical outcome in CHL.
  
  
  METHODS
  Participants were 324 consecutive CHL patients, comprising 132 patients with nodular sclerosis (NS), 35 patients with NS grade 2 (NS2), and 157 patients with mixed cellularity (MC). We evaluated the presenting features and prognosis of patients on categorization into four phenotypically defined groups: B-cell (CD20+ and/or CD79a+; n = 63), T-cell and/or cytotoxic molecules (CD3+, CD4+, CD8+, CD45RO+, TIA-1+, and/or granzyme B+; n = 27), FDC (CD21+ without B-cell marker; n = 22), and null-cell types (n = 212). Other potential prognostic factors were examined.
  
  
  RESULTS
  The T-cell and/or cytotoxic molecules group showed a significantly poorer prognosis than the other three groups (P < .0001). This finding was seen consistently in multivariate analyses. Morphologic subtyping (NS/NS2/MC) and Epstein-Barr virus positivity were not identified as independent prognostic factors.
  
  
  CONCLUSIONS
  The presence of T-cell and/or cytotoxic antigens in H-RS cells may represent a poor prognostic factor in CHL, even if their expression is not regarded as lineage specific. Examination of T-cell and/or cytotoxic molecules phenotype in CHL patients is recommended as a routine pathologic practice.
authors.affiliation: Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan. nasano@aichi-cc.jp
authors.forename: Naoko
authors.initials: N
authors.lastname: Asano
authors.forename: Aya
authors.initials: A
authors.lastname: Oshiro
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.forename: Yoshitoyo
authors.initials: Y
authors.lastname: Kagami
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Ishida
authors.forename: Ritsuro
authors.initials: R
authors.lastname: Suzuki
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Shimoyama
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Tamaru
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yoshino
authors.forename: Kunio
authors.initials: K
authors.lastname: Kitamura
authors.forename: Hisashi
authors.initials: H
authors.lastname: Fukutani
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishima
authors.forename: Shigeo
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006689:Hodgkin Disease / Q000097:blood* / Q000175:diagnosis*; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping / Q000379:methods; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011379:Prognosis; D013601:T-Lymphocytes / Q000378:metabolism*; D013602:T-Lymphocytes, Cytotoxic / Q000378:metabolism*; D016896:Treatment Outcome