title: [Expression of CD68, cyclin D1 and rearrangement of bcl-6 gene are adverse prognostic factors in diffuse large B-cell lymphoma].
abstract: OBJECTIVE
  To study expression of CD68, cyclin D1 protein and rearrangement of bcl-6 gene impact on the prognosis of diffuse large B-cell lymphoma (DLBCL).
  
  
  METHODS
  Gets paraffin samples of the 105 cases DLBCL with the detailed follow-up information, and were studied by using immunohistochemical EnVision method for CD3, CD10, CD20, CD68, cyclin D1, bcl-6, MUM 1, SOX-11 immunolabeling. The DLBCL were classified into germinal center B cell-like (GCB) subtypes and non-germinal center B cell-like (non-GCB) subtypes according to Hans'algorithm. Application of fluorescence in situ hybridization (FISH) technique to detect the bcl-6 gene rearrangement. The relationship between CD68, cyclin D1 protein, the bcl-6 gene and the curative effect of chemotherapy and survival was analyzed using statistical software. Respectively by GCB type, non-GCB type immune phenotype and CHOP, R-CHOP chemotherapy group, compare the curative effects.
  
  
  RESULTS
  105 patients had GCB 19 cases (18.1%), non-GCB 86 cases (81.9%), CD68 expression was 18 cases (17.1%), cyclin D1 high expression 36 cases (34.3%), bcl-6 gene rearrangement in 21 cases (21.9%), there is no correlation among the three (P > 0.05). One-way analysis of variance showed that age ≤ 60 years, clinical stage I-II, IPI score 0 to 2 points, LDH (U/L) < 245 IU/L,GCB subtypes, R-CHOP therapy, the prognosis of patients with better (P < 0.05), But gender, primary site no correlation with prognosis (P > 0.05). CD68, cyclin D1 high expression, bcl-6 rearrangement had poor prognosis (P < 0.05). Stratification analysis results show GCB-type or non-GCB type with high expression of CD68 contrast alloimmune phenotype groups had a poor prognosis, non-GCB type with high expression of cyclin D1 and rearrangement of bcl-6 gene had a poor prognosis (P < 0.001, P = 0.02). Treatment scheme of layered display, the CHOP treatment, significantly correlated with overall survival with high expression of CD68, cyclin D1 (P < 0.05), the R-CHOP treatment, there was no statistically significant difference between CD68, cyclin D1 high expression and overall survival (P = 0.428 and 0.168). Multivariate COX model analysis showed that high expression of CD68 (P = 0.026), high expression of cyclin D1 (P = 0.003) and high levels of LDH (P = 0.005) were adverse prognostic factors independent.
  
  
  CONCLUSIONS
  high expression of CD68, cyclin D1 and rearrangement of bcl-6 gene suggests poor prognosis, CD68, cyclin D1 protein and bcl-6 gene can be used as a prognostic indicator in patients with DLBCL.
authors.affiliation: Department of Pathology, Shanxi Cancer Hospital, Shanxi Medical University, Taiyuan 030013, China.
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Liang
authors.affiliation: Department of Pathology, Shanxi Cancer Hospital, Shanxi Medical University, Taiyuan 030013, China; E-mail: jfenw@hotmail.com.
authors.forename: Jinfen
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Pathology, Shanxi Cancer Hospital, Shanxi Medical University, Taiyuan 030013, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Bai
authors.affiliation: Department of Pathology, Shanxi Cancer Hospital, Shanxi Medical University, Taiyuan 030013, China.
authors.forename: Ruifang
authors.initials: R
authors.lastname: Sun
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD / Q000378:metabolism*; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism*; D000971:Antineoplastic Combined Chemotherapy Protocols; D001402:B-Lymphocytes / Q000145:classification; D019938:Cyclin D1 / Q000378:metabolism*; D003520:Cyclophosphamide; D004268:DNA-Binding Proteins / Q000235:genetics*; D004317:Doxorubicin; D015321:Gene Rearrangement; D018858:Germinal Center / Q000166:cytology; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis*; D011241:Prednisone; D011379:Prognosis; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab; D014750:Vincristine; D000097382:CD68 Molecule
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D019938:Cyclin D1; D003520:Cyclophosphamide; D004268:DNA-Binding Proteins; D004317:Doxorubicin; D011241:Prednisone; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab; D014750:Vincristine; C084103:BCL6 protein, human; C530104:CCND1 protein, human; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C571759:R-CHOP protocol