title: Expression of BAFF and BAFF-R in follicular lymphoma: correlation with clinicopathologic characteristics and survival outcomes.
abstract: BACKGROUND
  B-cell activation factor (BAFF) and BAFF-receptor (BAFF-R) play crucial roles in the viability and proliferation of malignant lymphoma cells. Limited information exists regarding expression profiles and the prognostic role of BAFF and BAFF-R in follicular lymphoma (FL). We sought to determine the expression profiles of BAFF and BAFF-R in FL and to evaluate the correlation of BAFF and BAFF-R expression with clinicopathologic characteristics and outcome of FL. Correlation between expression levels of BAFF detected by immunohistochemical (IHC) and serum levels of BAFF was also evaluated.
  
  
  METHODS
  Paraffin-embedded specimens from 115 patients were immunohistochemically examined for BAFF and BAFF-R expression. Expression levels were dichotomized into low versus high categories based on immunostaining intensity. The correlation of BAFF and BAFF-R expression with clinicopathologic characteristics and patient outcome was assessed. Serum levels of BAFF in 35 of the 115 patients with IHC data were measured by Enzyme-linked Immunosorbent assay (ELISA).
  
  
  RESULTS
  BAFF and BAFF-R were expressed in 88.7% (102/115) and 87.8% (101/115) of the cases, respectively. BAFF expression was significantly correlated with only one clinicopathologic feature: Ann Arbor stage. No significant correlation was found between expression levels of BAFF detected by IHC and serum levels of BAFF detected by ELISA. High expression of BAFF-R, but not BAFF, was significantly correlated with inferior progression-free survival (PFS; P = 0.013) and overall survival (OS; P = 0.03). High expression of BAFF-R, bulky disease, and elevated lactate dehydrogenase were correlated with inferior PFS and OS in multivariate analysis. A prognostic scoring system incorporating these 3 risk factors identified 3 distinct prognostic groups with 5-year PFS of 59.4%, 41.9%, and 10.7% and OS of 91.3%, 79.7%, and 45.8%, respectively.
  
  
  CONCLUSIONS
  Most patients with FL variably express BAFF and BAFF-R. High expression of BAFF-R, but not BAFF, may be an independent risk factor for PFS and OS in FL.
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China.
authors.forename: Ya-Jun
authors.initials: YJ
authors.lastname: Li
authors.forename: Wen-Qi
authors.initials: WQ
authors.lastname: Jiang
authors.forename: Hui-Lan
authors.initials: HL
authors.lastname: Rao
authors.forename: Jia-Jia
authors.initials: JJ
authors.lastname: Huang
authors.forename: Yi
authors.initials: Y
authors.lastname: Xia
authors.forename: Hui-Qiang
authors.initials: HQ
authors.lastname: Huang
authors.forename: Tong-Yu
authors.initials: TY
authors.lastname: Lin
authors.forename: Zhong-Jun
authors.initials: ZJ
authors.lastname: Xia
authors.forename: Su
authors.initials: S
authors.lastname: Li
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D053264:B-Cell Activating Factor / Q000096:biosynthesis*; D053265:B-Cell Activation Factor Receptor / Q000096:biosynthesis*; D049109:Cell Proliferation; D002470:Cell Survival; D018572:Disease-Free Survival; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008224:Lymphoma, Follicular / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D053264:B-Cell Activating Factor; D053265:B-Cell Activation Factor Receptor; C505719:TNFSF13B protein, human