Prognostic impact of C-REL expression in diffuse large B-cell lymphoma.
Prognostic impact of C-REL expression in diffuse large B-cell lymphoma.
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DOI：
10.1007/s12308-009-0021-4
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发表时间：
2009-03
影响因子：
0.6
通讯作者：
Chang, Chung-Che
中科院分区：
文献类型：
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作者：
Curry, Choladda V;Ewton, April A;Olsen, Randall J;Logan, Brent R;Preti, Hector A;Liu, Yao-Chang;Perkins, Sherrie L;Chang, Chung-Che
具有生发中心B细胞（GCB）表型的弥漫性大B细胞淋巴瘤（DLBCL）被认为比具有活化B细胞（ABC）表型的DLBCL具有更好的预后。以往的研究表明核因子-κB（NF-κB）活化在DLBCL的ABC亚型中起重要作用，而c-REL扩增与GCB亚型相关。使用免疫组化技术，我们检查了68例新诊断的原发DLBCL病例（中位随访44个月，范围1至142个月）的c-REL，BCL-6，CD 10和MUM 1/IRF 4的表达。44例（65%）c-REL核表达阳性。在该患者队列中，GCB表型与比非GCB表型更好的总生存期（OS）相关（Kaplan-Meier生存期（KMS）分析，p = 0.016，Breslow-Gehan-Wilcoxon检验）。一般来说，c-REL核表达与GCB与非GCB表型、国际预后指数评分或OS无关。然而，GCB表型和核c-REL阴性的病例比GCB表型和核c-REL阳性的病例表现出更好的OS（KMS分析，p = 0.045，Breslow-Gehan-Wilcoxon检验），而在具有非GCB表型的病例中，c-REL的表达不显著影响预后。这些结果表明，c-REL核表达可能是DLBCL的一个预后因素，它可以改善患者的风险分层与GCB/非GCB表型相结合。
Diffuse large B-cell lymphoma (DLBCL) with a germinal center B-cell (GCB) phenotype is believed to confer a better prognosis than DLBCL with an activated B-cell (ABC) phenotype. Previous studies have suggested that nuclear factor-κB (NF-κB) activation plays an important role in the ABC subtype of DLBCL, whereas c-REL amplification is associated with the GCB subtype. Using immunohistochemical techniques, we examined 68 newly diagnosed de novo DLBCL cases (median follow-up 44 months, range 1 to 142 months) for the expression of c-REL, BCL-6, CD10, and MUM1/IRF4. Forty-four (65%) cases demonstrated positive c-REL nuclear expression. In this cohort of patients, the GCB phenotype was associated with a better overall survival (OS) than the non-GCB phenotype (Kaplan–Meier survival (KMS) analysis, p = 0.016, Breslow–Gehan–Wilcoxon test). In general, c-REL nuclear expression did not correlate with GCB vs. non-GCB phenotype, International Prognostic Index score, or OS. However, cases with a GCB phenotype and negative nuclear c-REL demonstrated better OS than cases with a GCB phenotype and positive nuclear c-REL (KMS analysis, p = 0.045, Breslow–Gehan–Wilcoxon test), whereas in cases with non-GCB phenotype, the expression of c-REL did not significantly impact the prognosis. These results suggest that c-REL nuclear expression may be a prognostic factor in DLBCL and it may improve patient risk stratification in combination with GCB/non-GCB phenotyping.