Prognostic impact of MYC protein expression in central nervous system diffuse large B-cell lymphoma: comparison with MYC rearrangement and MYC mRNA expression.
The prognostic role of MYC has been well documented in non-central nervous system diffuse large B-cell lymphoma; however, it remains controversial in central nervous system diffuse large B-cell lymphoma. To investigate the prognostic value of MYC, we analyzed the MYC protein expression by immunohistochemistry, mRNA expression by RNA in situ hybridization, and gene status by fluorescence in situ hybridization in 74 cases of central nervous system diffuse large B-cell lymphoma. Moreover, we examined the correlation between MYC translocation, mRNA expression, and protein expression. The mean percentage of MYC immunopositive cells was 49%. Using a 44% cutoff value, 49 (66%) cases showed MYC protein overexpression. The result of mRNA in situ hybridization using the RNA scope technology was obtained using the H-scoring system; the median value was 34.2. Using the cutoff value of 63.5, 16 (22%) cases showed MYC mRNA overexpression. MYC gene rearrangement was detected in five out of 68 (7%) cases. MYC translocation showed no statistically significant correlation with mRNA expression; however, all MYC translocation-positive cases showed MYC protein overexpression, with a higher mean percentage of MYC protein expression than that of translocation-negative cases (78 vs 48%, P=0.001). The level of MYC mRNA expression was moderately correlated with the level of MYC protein expression (P<0.001). The mean percentage of MYC protein expression in the high MYC mRNA group was higher than that in the low MYC mRNA group (70 vs 47%, P<0.001). A univariate analysis showed that age over 60 years, Eastern Cooperative Oncology Group (ECOG) performance status ≥2 and MYC protein overexpression were significantly associated with an increased risk of death. MYC translocation and MYC mRNA expression had no prognostic significance. On multivariate analysis, MYC protein overexpression and ECOG score retained prognostic significance.
Department of Pathology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
Seung-Myoung
SM
Son
Department of Pathology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
Sang-Yun
SY
Ha
Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.|Samsung Biomedical Research Institute, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
Hae-Yong
HY
Yoo
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
Dongryul
D
Oh
Samsung Biomedical Research Institute, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.|Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
Seok-Jin
SJ
Kim
Samsung Biomedical Research Institute, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.|Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
Won-Seog
WS
Kim
Department of Pathology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.|Samsung Biomedical Research Institute, Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
Young-Hyeh
YH
Ko
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D016543:Central Nervous System Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D005260:Female; D015321:Gene Rearrangement; D006801:Humans; D007150:Immunohistochemistry; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics / Q000378:metabolism*; D055815:Young Adult
D014408:Biomarkers, Tumor; C489427:MYC protein, human; D016271:Proto-Oncogene Proteins c-myc
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