title: Bcl-6 protein expression, and not the germinal centre immunophenotype, predicts favourable prognosis in a series of primary nodal diffuse large B-cell lymphomas: a single centre experience.
abstract: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease. The immunohistochemistry-based algorithms for the determination of the cell of origin of DLBCL have been proposed as a practical method to validate and surrogate results obtained by gene expression profiling. We studied 71 patients with primary nodal DLBCL at diagnosis, who received anthracycline-based therapy with or without rituximab. Immunohistochemistry was performed using anti-CD10, Bcl-6, MUM1 and Bcl-2 antibodies in order to assess the ontogenic profile of neoplastic cells and to verify its relation with clinical outcome. Survival data were analysed using an explorative Cox model. The immunohistochemistry-based algorithms for the determination of the cell of origin of DLBCL were not associated with prognosis. By contrast, Bcl-6 expression was associated with a longer lymphoma-free survival while immunoreactivities for MUM1 or Bcl-2 were not significantly related to patient outcome. Bcl-6 expression alone proved to be a prognostic marker in primary nodal DLBCL and seemed to be more reliable to predict clinical outcome in these disorders than the immunohistochemical algorithms for the detection of the germinal centre/non-germinal centre immunophenotype.
authors.affiliation: Department of Human Morphology, Pathology Unit, University of Insubria, Varese, Italy. silvia.uccella@uninsubria.it
authors.forename: Silvia
authors.initials: S
authors.lastname: Uccella
authors.forename: Claudia
authors.initials: C
authors.lastname: Placidi
authors.forename: Silvia
authors.initials: S
authors.lastname: Marchet
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Cergnul
authors.forename: Ilaria
authors.initials: I
authors.lastname: Proserpio
authors.forename: Claudio
authors.initials: C
authors.lastname: Chini
authors.forename: Raffaele
authors.initials: R
authors.lastname: Novario
authors.forename: Graziella
authors.initials: G
authors.lastname: Pinotti
authors.forename: Carlo
authors.initials: C
authors.lastname: Capella
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D018943:Anthracyclines / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D018572:Disease-Free Survival; D005260:Female; D018858:Germinal Center / Q000473:pathology*; D006801:Humans; D016130:Immunophenotyping; D050835:Interferon Regulatory Factors / Q000032:analysis; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D051560:Proto-Oncogene Proteins c-bcl-6 / Q000032:analysis*; D000069283:Rituximab; D016896:Treatment Outcome; D000099218:Interferon Regulatory Factor-4
chemical_list: D018943:Anthracyclines; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D050835:Interferon Regulatory Factors; D019253:Proto-Oncogene Proteins c-bcl-2; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab; D000099218:Interferon Regulatory Factor-4