Prognostic value of immunohistochemical algorithms in gastrointestinal diffuse large B-cell lymphoma.
Prognostic value of immunohistochemical algorithms in gastrointestinal diffuse large B-cell lymphoma.
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DOI：
10.5045/br.2013.48.4.266
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发表时间：
2013-12
期刊：
影响因子：
2.2
通讯作者：
Huh J
中科院分区：
文献类型：
--
作者：
Hwang HS;Yoon DH;Suh C;Park CS;Huh J
弥漫性大B细胞淋巴瘤（DLBCL）是一种异质性的临床病理实体，其基因表达谱分析将其分为生发中心B细胞样（GCB）和活化B细胞样（ABC）亚型已被证明具有预后意义。尽管免疫组化分类的临床效用仍不确定，但最近已尝试寻找免疫组化结果与分子亚组之间的关联。分析68例手术切除的胃肠道DLBCL的临床病理特征及随访资料。使用组织芯片上的免疫组化结果，根据Hans，Muris，Choi和Tally提出的算法将病例分为GCB和非GCB亚型。患者的中位年龄为56岁（范围：26-77岁）。在纳入的68例病例中，39.7%（27/68）累及胃，60.3%（41/68）累及肠。根据Hans、Choi和Tally算法（而非Muris算法）分类的GCB组和非GCB组非常一致（Hans vs. Choi，κ=0.775，P<0.001; Hans vs. Tally，κ=0.724，P<0.001; Choi vs. Tally，κ=0.528，P<0.001）。然而，无论使用何种算法，GCB和非GCB亚型之间的预后没有差异。单因素生存分析中，国际预后指数、危险组和肿瘤浸润深度对预后有意义。Hans、Choi和Tally算法可能代表相同的DLBCL亚组，但这种分组与预后无关。进一步的研究可能会描述免疫组化亚组与预后之间的关系。
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous clinicopathological entity, and its molecular classification into germinal center B cell-like (GCB) and activated B cell-like (ABC) subtypes using gene expression profile analysis has been shown to have prognostic significance. Recent attempts have been made to find an association between immunohistochemical findings and molecular subgroup, although the clinical utility of immunohistochemical classification remains uncertain. The clinicopathological features and follow-up data of 68 cases of surgically resected gastrointestinal DLBCL were analyzed. Using the immunohistochemical findings on tissue microarray, the cases were categorized into GCB and non-GCB subtypes according to the algorithms proposed by Hans, Muris, Choi, and Tally. The median patient age was 56 years (range, 26-77 years). Of the 68 cases included, 39.7% (27/68) involved the stomach, and 60.3% (41/68) involved the intestines. The GCB and non-GCB groups sorted according to Hans, Choi, and Tally algorithms, but not the Muris algorithm, were closely concordant (Hans vs. Choi, κ=0.775, P<0.001; Hans vs. Tally, κ=0.724, P<0.001; Choi vs. Tally, κ=0.528, P<0.001). However, there was no prognostic difference between the GCB and non-GCB subtypes, regardless of the algorithm used. On univariate survival analyses, international prognostic index risk group and depth of tumor invasion both had prognostic significance. The Hans, Choi, and Tally algorithms might represent identical DLBCL subgroups, but this grouping did not correlate with prognosis. Further studies may delineate the association between immunohistochemical subgroups and prognosis.