title: Nasal-type NK/T-cell lymphomas are more frequently T rather than NK lineage based on T-cell receptor gene, RNA, and protein studies: lineage does not predict clinical behavior.
abstract: Extranodal natural killer (NK)/T-cell lymphoma (ENKTL), nasal type, comprises NK or cytotoxic T cells. We evaluated the clinical impact of cell type and the usefulness of T-cell receptor (TCR) gene transcripts in distinguishing cell lineage. One hundred and eight cases of ENKTL were analyzed for TCR gene rearrangements using the BIOMED-2 protocol and for TCR gene expression using immunohistochemistry for TCR-βF1 and TCR-cγM1, and RNA in situ hybridization for TCR gene transcripts. Prognostic factors were analyzed. Among the 108 cases, 44 were monoclonal for a TCR rearrangement (40%) while 64 (60%) were undefinable. The monoclonal cases expressed TCR-βF1 in 14 out of 40 cases (35%) and TCR-cγM1 in 1 out of 44 cases (2%). The 64 undetermined cases expressed TCR-βF1 in 15 cases (23%) and TCR-cγM1 in 1 (2%). Thirteen of 40 TCR-β constant gene transcript-positive cases (33%) expressed TCR-βF1 and one of nine TCR-γ constant gene transcript-positive cases (11%) expressed TCR-cγM1. TCR gene transcripts were not useful in the distinction of cell lineages. TCR gene transcripts were positive in ENKTLs as well as in normal B cells and aggressive NK-cell leukemia. Based on gene rearrangements and immunohistochemistry for TCR, there were 60 T-cell type cases (56%), 32 NK-cell type cases (30%), and 16 cases with an undetermined cell type (14%). TCR protein was expressed in 30/60 T-ENKTLs (50%) in a variable fraction of tumor cells. There were no significant differences in clinical findings or overall patient survival between T- or NK-cell types of ENKTL, although those with a T-cell type tended to show a better prognosis for those with localized nasal lymphomas. Univariate and multivariate analysis showed that a non-nasal ENKTL, age >60 years, high level of lactate dehydrogenase, bone marrow involvement, and the absence of radiotherapy were independent prognostic factors.
authors.affiliation: Department of Pathology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.|Hallym University, Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Mineui
authors.initials: M
authors.lastname: Hong
authors.affiliation: Department of Pathology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
authors.forename: Taehee
authors.initials: T
authors.lastname: Lee
authors.affiliation: Department of Pathology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
authors.forename: So
authors.initials: S
authors.lastname: Young Kang
authors.affiliation: Section of Hematology-Oncology, Internal Medicine, Samsung Medical Center, Seoul, Korea.
authors.forename: Suk-Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Section of Hematology-Oncology, Internal Medicine, Samsung Medical Center, Seoul, Korea.
authors.forename: Wonseog
authors.initials: W
authors.lastname: Kim
authors.affiliation: Department of Pathology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
authors.forename: Young-Hyeh
authors.initials: YH
authors.lastname: Ko
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019070:Cell Lineage; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000473:pathology*; D054391:Lymphoma, Extranodal NK-T-Cell / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012313:RNA / Q000235:genetics; D011948:Receptors, Antigen, T-Cell / Q000235:genetics*; D013601:T-Lymphocytes / Q000473:pathology*; D055815:Young Adult
chemical_list: D011948:Receptors, Antigen, T-Cell; D012313:RNA