Investigation of molecular genetic alterations and prognostic factors of primary central nervous system lymphoma

我们用免疫组化方法研究了原发性中枢神经系统淋巴瘤（PCNSL）的预后标志物。如前所述，年龄和KPS是强有力的预测因素。以甲氨蝶呤为基础的放化疗达到了很高的完全缓解率（83%），提高了PCNSL患者的生存率。PCNSL病变的多发性与生存期短显著相关。LRP（药物外排泵蛋白）的高表达与化疗反应差和总生存期短相关，表明LRP可能是PCNSL中临床相关的耐药因素。生发中心标志物Bcl-6的表达是一个有利的预后因素，而c-myc高蛋白表达与较差的生存率相关。错配修复蛋白MLH 1、MSH 2和MSH 6的低蛋白表达是PCNSL患者生存期短的重要指标。

We investigated prognostic markers for primary central nervous system lymphoma (PCNSL) using immunohistochemistry. Age and KPS were strong prognosticators as reported previously. Methotrexate-based chemoradiotherapy achieved a high rate of complete response (83%), improving survival of PCNSL patients. Multiplicity of PCNSL lesions was significantly associated with a short survival. High expression of LRP, drug efflux pump protein, was associated with a poor response to chemotherapy and shorter overall survival, suggesting that LRP may be a clinically relevant drug-resistance factor in PCNSL. Expression of a germinal center marker Bcl-6 was a favorable prognostic factor, whereas c-myc high protein expression was associated with an inferior survival. Low protein expression of mismatch repair proteins, MLH1, MSH2 and MSH6, was a significant indicator for a short survival in patients with PCNSL.