Marker expression in peripheral T-cell lymphoma: A proposed clinical-pathologic prognostic score
Marker expression in peripheral T-cell lymphoma: A proposed clinical-pathologic prognostic score
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DOI：
10.1200/jco.2005.03.6327
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发表时间：
2006-06-01
影响因子：
45.3
通讯作者：
Pileri, Stefano A.
中科院分区：
文献类型：
--
作者：
Went, Philip;Agostinelli, Claudio;Pileri, Stefano A.
目的：尽管外周T细胞淋巴瘤(PTCL/U)是西方国家最常见的T细胞肿瘤，但迄今还没有一项研究是基于对大量患者应用广泛的标记物，并评估表型对生存的影响。方法采用免疫组织化学和原位杂交方法对148例PTCL/U和45例血管免疫母细胞型(AILD)PTCL中19种标志物的表达进行检测。93例PTCL/U患者有临床资料，其中大多数已纳入先前提出预后指数(PIT)的研究。结果无论是U还是AILD，PTCL的典型表型均为CD5和/或CD7频繁丢失。异常表达的蛋白质很少包括CD20、CD15和CD30。EB病毒相关小RNA和CD15表达阳性是不良预后因素。在PTCL/U中，增殖相关蛋白Ki-67与预后相关，并被整合到一个新的预测评分中，包括年龄(>；60岁)、乳酸脱氢酶高、表现状态差以及Ki-67>；=80%。这一评分与患者的预后相关(P<；.0001)，并且在本系列中被发现比PIT(P<；.0043)更可靠。结论我们的回顾分析显示了PTCL中广泛的蛋白表达，并提出了一个新的预后指标。后者代表了混合评分(包括患者和肿瘤特异性因素)应用于恶性淋巴瘤的首批例子之一，并可能成为未来前瞻性治疗试验的基础。
Purpose Although peripheral T-cell lymphoma, unspecified (PTCL/U), is the most common T-cell tumor in Western countries, no study to date has been based on the application of a wide panel of markers to a large series of patients and assessed the impact of phenotype on survival. We evaluated the expression of 19 markers in 148 PTCLs/U and 45 PTCLs of the angioimmunoblastic type (AILD).Patients and Methods The analysis was performed on tissue microarrays by immunohistochemistry and in situ hybridization. Clinical data were available in 93 PTCL/U patients, most of whom had been included in a previous study proposing a prognostic index (PIT).Results An aberrant phenotype with frequent loss of CD5 and/or CD7 was typical for PTCLs, irrespective of whether they were U or AILD. Aberrantly expressed proteins rarely included CD20, CD15, and CD30. Positivity for Epstein-Barr virus-associated small RNAs and CD15 expression emerged as adverse prognostic factors. Among PTCLs/U, the proliferation-associated protein Ki-67 turned out to be prognostically relevant and was integrated in a new predictive score, incorporating age (> 60 years), high lactate dehydrogenase, poor performance status, and Ki-67 >= 80%. This score was associated with the patient outcome (P < .0001) and was found to be more robust than PIT (P < .0043) in the present series.Conclusion Our retrospective analysis shows a wide range of protein expression in PTCLs and proposes a new prognostic index. The latter represents one of the first examples of mixed score (including patient- and tumor-specific factors) applied to malignant lymphomas and may be the basis for future prospective therapeutic trials.