Immunohistochemical Methods for Predicting Cell of Origin and Survival in Patients With Diffuse Large B-Cell Lymphoma Treated With Rituximab
Immunohistochemical Methods for Predicting Cell of Origin and Survival in Patients With Diffuse Large B-Cell Lymphoma Treated With Rituximab
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DOI：
10.1200/jco.2010.30.0368
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发表时间：
2011-01-10
影响因子：
45.3
通讯作者：
Weisenburger, Dennis D.
中科院分区：
文献类型：
--
作者：
Meyer, Paul N.;Fu, Kai;Weisenburger, Dennis D.
目的
通过微阵列分析确定肿瘤的细胞起源，弥漫性大B细胞淋巴瘤（DLBCL）患者可被分为不同的预后组。已开发出多种免疫组化算法来复制这些微阵列结果和/或根据生存期对患者进行分层。本研究对其中一些算法进行了比较，并提出了一些改进措施。
患者与方法
对262例接受利妥昔单抗联合环磷酰胺、多柔比星、长春新碱和泼尼松（CHOP）或类CHOP方案治疗的初治DLBCL患者进行了研究。
结果
崔（Choi）算法和汉斯（Hans）算法与微阵列结果高度一致。为便于使用对崔氏和汉斯算法进行的修改仍然与微阵列结果保持高度一致。尽管尼曼（Nyman）算法和穆里斯（Muris）算法与微阵列结果高度一致，但二者在敏感性或特异性方面的值均较低。单独使用LMO2与微阵列结果的一致性最低。一种新的算法（塔利，Tally）使用多种抗体组合，且不考虑检测顺序，与微阵列结果的一致性最高。所有算法都将患者分为总生存期和无事件生存期显著不同的组，但风险比不同。除尼曼算法外，这种生存期预测与国际预后指数无关。尽管穆里斯算法具有预后意义，但它将大量活化B细胞型DLBCL病例错误分类。
结论
塔利算法在与微阵列数据一致性方面表现最佳，同时保持了预后意义和易用性。《临床肿瘤学杂志》29:200 - 207。（C）2010年美国临床肿瘤学会
PurposePatients with diffuse large B-cell lymphoma (DLBCL) can be divided into prognostic groups based on the cell of origin of the tumor as determined by microarray analysis. Various immunohistochemical algorithms have been developed to replicate these microarray results and/or stratify patients according to survival. This study compares some of those algorithms and also proposes some modifications.Patients and MethodsTwo-hundred and sixty-two cases of de novo DLBCL treated with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like therapy were examined.ResultsThe Choi algorithm and Hans algorithm had high concordance with the microarray results. Modifications of the Choi and Hans algorithms for ease of use still retained high concordance with the microarray results. Although the Nyman and Muris algorithms had high concordance with the microarray results, each had a low value for either sensitivity or specificity. The use of LMO2 alone showed the lowest concordance with the microarray results. A new algorithm (Tally) using a combination of antibodies, but without regard to the order of examination, showed the greatest concordance with microarray results. All of the algorithms divided patients into groups with significantly different overall and event-free survivals, but with different hazard ratios. With the exception of the Nyman algorithm, this survival prediction was independent of the International Prognostic Index. Although the Muris algorithm had prognostic significance, it misclassified a large number of cases with activated B-cell type DLBCL.ConclusionThe Tally algorithm showed the best concordance with the microarray data while maintaining prognostic significance and ease of use. J Clin Oncol 29:200-207. (C) 2010 by American Society of Clinical Oncology