The Stromal Cell Marker SPARC Predicts for Survival in Patients With Diffuse Large B-Cell Lymphoma Treated With Rituximab
The Stromal Cell Marker SPARC Predicts for Survival in Patients With Diffuse Large B-Cell Lymphoma Treated With Rituximab
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DOI：
10.1309/ajcpjx4bjv9nlqhy
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发表时间：
2011-01-01
影响因子：
3.5
通讯作者：
Weisenburger, Dennis D.
中科院分区：
文献类型：
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作者：
Meyer, Paul N.;Fu, Kai;Weisenburger, Dennis D.
肿瘤微环境的细胞组成可能影响弥漫性大 B 细胞淋巴瘤 (DLBCL) 的生存。我们对 262 名接受利妥昔单抗和环磷酰胺、阿霉素、长春新碱和泼尼松 (CHOP) 或类似 CHOP 疗法治疗的 DLBCL 患者进行了 2 种基质细胞标记物 CD68 和 SPARC（分泌蛋白，酸性且富含半胱氨酸）的免疫染色。微环境中具有任何 SPARC+ 细胞的患者的总生存期显着较长，并且微环境中 SPARC 高阳性的患者的无事件生存期也显着较长。生存差异主要是由于 SPARC+ 细胞对活化 B 细胞 (ABC) 型 DLBCL 的预后影响，而对生发中心 B 细胞型 DLBCL 没有影响。在检查的临床特征中，只有结外部位的数量与 SPARC 表达显着相关。多变量分析显示，SPARC 表达可预测患者的生存，与国际预后指数或肿瘤细胞来源无关。 DLBCL 微环境中的 SPARC 表达可用于预后目的，确定具有显着更长生存期的 ABC DLBCL 患者亚组。对于没有 SPARC+ 基质细胞的 ABC DLBCL 患者，应考虑更积极的化疗方案。微环境中细胞的 CD68 表达并不能预测生存。
The cellular composition of the tumor microenvironment may affect survival in diffuse large B-cell lymphoma (DLBCL). We performed immunostains for 2 stromal cell markers, CD68 and SPARC (secreted protein, acidic and rich in cysteine), in 262 patients with DLBCL treated with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like therapies. Patients with any SPARC+ cells in the microenvironment had a significantly longer overall survival, and patients with high SPARC positivity in the microenvironment also had a significantly longer event free survival. Survival differences were mainly due to the prognostic effect of SPARC+ cells in activated B-cell (ABC)-type DLBCL, with no effect found in the germinal center B-cell type DLBCL. Of clinical features examined, only the number of extranodal sites was significantly associated with SPARC expression. Multivariate analysis revealed that SPARC expression predicted patient survival independent of the International Prognostic Index or tumor cell of origin. SPARC expression in the microenvironment of DLBCL can be used for prognostic purposes, determining a subgroup of patients with ABC DLBCL who have significantly longer survival. More aggressive chemotherapy protocols should be considered for patients with ABC DLBCL without SPARC+ stromal cells. CD68 expression by cells in the microenvironment did not predict survival.