title: Absence of cyclin-D2 and Bcl-2 expression within the germinal centre type of diffuse large B-cell lymphoma identifies a very good prognostic subgroup of patients.
abstract: OBJECTIVE
  To validate and improve the existing algorithm (proposed by Hans et al.) to classify diffuse large B-cell lymphoma (DLBCL).
  
  
  RESULTS
  Tissue microarrays constructed from 81 patients with DLBCL were studied by immunohistochemistry for expression of CD10, Bcl-6, MUM1, Bcl-2, cyclin-D2, FOXP1 and PKC-gamma proteins. Cases were classified as either germinal centre B-like (GCB) or non-GC according to Hans et al. An alternative classification was also employed, in which cases positive for either CD10 or Bcl-6 were considered as a GC subgroup and cases negative for both CD10 and Bcl-6 were considered as a non-GC subgroup. GC was further subdivided into favourable GC (negative for both Bcl-2 and cyclin-D2) and unfavourable GC (positive for either Bcl-2 or cyclin-D2). The 5-year event-free survival (EFS) amongst patients classified as favourable GC versus 'others' was 49.5% and 7.3%, respectively (log rank P < 0.0001). Similarly, the 5-year overall survival (OS) amongst patients classified as favourable GC versus 'others' was 58.6% and 13.7%, respectively (log rank P = 0.0001). The difference in survival was independent of the international prognostic index.
  
  
  CONCLUSIONS
  In this group of patients the risk stratification based on the new algorithm was better than that proposed by Hans et al.
authors.affiliation: Department of Histopathology, Hammersmith Hospital & Imperial College, London, UK.
authors.forename: F
authors.initials: F
authors.lastname: Amen
authors.forename: D
authors.initials: D
authors.lastname: Horncastle
authors.forename: K
authors.initials: K
authors.lastname: Elderfield
authors.forename: A H
authors.initials: AH
authors.lastname: Banham
authors.forename: M
authors.initials: M
authors.lastname: Bower
authors.forename: D
authors.initials: D
authors.lastname: Macdonald
authors.forename: E
authors.initials: E
authors.lastname: Kanfer
authors.forename: K N
authors.initials: KN
authors.lastname: Naresh
mesh_terms: D000465:Algorithms; D014408:Biomarkers, Tumor / Q000378:metabolism; D056742:Cyclin D2; D016213:Cyclins / Q000235:genetics / Q000378:metabolism*; D015972:Gene Expression Regulation, Neoplastic; D018858:Germinal Center / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D008875:Middle Aged; D015260:Neprilysin / Q000235:genetics / Q000378:metabolism; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics / Q000378:metabolism*; D051560:Proto-Oncogene Proteins c-bcl-6 / Q000235:genetics / Q000378:metabolism; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; C080336:CCND2 protein, human; D056742:Cyclin D2; D016213:Cyclins; D019253:Proto-Oncogene Proteins c-bcl-2; D051560:Proto-Oncogene Proteins c-bcl-6; D015260:Neprilysin