Gene-expression profiling and not immunophenotypic algorithms predicts prognosis in patients with diffuse large B-cell lymphoma treated with immunochemotherapy
Gene-expression profiling and not immunophenotypic algorithms predicts prognosis in patients with diffuse large B-cell lymphoma treated with immunochemotherapy
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DOI：
10.1182/blood-2010-12-322362
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发表时间：
2011-05-05
期刊：
影响因子：
20.3
通讯作者：
Lopez-Guillermo, Armando
中科院分区：
文献类型：
--
作者：
Gutierrez-Garcia, Gonzalo;Cardesa-Salzmann, Teresa;Lopez-Guillermo, Armando
弥漫性大B细胞淋巴瘤（DLBCL）可通过基因表达谱（GEP）分为生殖中心B细胞样（GCB）和活化B细胞样（ABC）亚型，后者显示较差的预后。虽然这种分类可以通过不同的免疫染色算法来模仿，但它们的可靠性是有争议的。我们用157例免疫化疗均匀治疗的DLBCL患者的样本构建了组织微阵列，以应用以下算法：科洛莫（MUM 1/IRF 4、CD 10和BCL 6抗原），Hans（CD 10、BCL 6和MUM 1/IRF 4），小鼠（CD 10和MUM 1/IRF 4加BCL 2）、Choi（GCET 1、MUM 1/IRF 4、CD 10、FOXP 1和BCL 6）和Tally（CD 10、GCET 1、MUM 1/IRF 4、FOXP 1和LMO 2）。在62个案例中提供了两性平等观点信息。在定义GCB亚群时，免疫组化的错误分类病例比例高于GEP：Colomo、Hans、Muris、Choi和Tally分别为41%、48%、30%、60%和40%。然而GEP组显示出显著不同的5年无进展生存率（GCB和活化DLBCL为76% vs 31%）和总生存率（80% vs 45%），没有一种免疫染色算法能够保留各组（GCB vs非GCB）的预后影响。总之，基于免疫染色算法的分层应谨慎用于指导治疗，即使在临床试验中。（血。2011; 117（18）：4836-4843）
Diffuse large B-cell lymphomas (DLBCLs) can be divided into germinal-center B cell-like (GCB) and activated-B cell-like (ABC) subtypes by gene-expression profiling (GEP), with the latter showing a poorer outcome. Although this classification can be mimicked by different immunostaining algorithms, their reliability is the object of controversy. We constructed tissue microarrays with samples of 157 DLBCL patients homogeneously treated with immunochemotherapy to apply the following algorithms: Colomo (MUM1/IRF4, CD10, and BCL6 antigens), Hans (CD10, BCL6, and MUM1/IRF4), Muris (CD10 and MUM1/IRF4 plus BCL2), Choi (GCET1, MUM1/IRF4, CD10, FOXP1, and BCL6), and Tally (CD10, GCET1, MUM1/IRF4, FOXP1, and LMO2). GEP information was available in 62 cases. The proportion of misclassified cases by immunohistochemistry compared with GEP was higher when defining the GCB subset: 41%, 48%, 30%, 60%, and 40% for Colomo, Hans, Muris, Choi, and Tally, respectively. Whereas the GEP groups showed significantly different 5-year progression-free survival (76% vs 31% for GCB and activated DLBCL) and overall survival (80% vs 45%), none of the immunostaining algorithms was able to retain the prognostic impact of the groups (GCB vs non-GCB). In conclusion, stratification based on immunostaining algorithms should be used with caution in guiding therapy, even in clinical trials. (Blood. 2011; 117(18): 4836-4843)