Expression of CD68, cyclin D1 and rearrangement of bcl-6 gene are adverse prognostic factors in diffuse large B-cell lymphoma
10.3760/cma.j.issn.0529-5807.2015.08.004
- VernacularTitle:CD68、cyclin D 1蛋白和 bcl-6基因在弥漫性大 B 细胞淋巴瘤中的表达及意义
- Author:
Xiaojie LIANG
1
;
Jinfen WANG
;
Wei BAI
;
Ruifang SUN
Author Information
1. 山西省肿瘤医院病理科
- Keywords:
Lymphoma,large B-cell,diffuse;
Cyclin D1;
Genes,bcl-6;
Prognosis
- From:
Chinese Journal of Pathology
2015;(8):559-564
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study expression of CD68, cyclin D1 protein and rearrangement of bcl-6 gene impact on the prognosis of diffuse large B-cell lymphoma ( DLBCL).Methods Gets paraffin samples of the 105 cases DLBCL with the detailed follow-up information , and were studied by using immunohistochemical EnVision method for CD 3, CD10, CD20, CD68, cyclin D1, bcl-6, MUM 1, SOX-11 immunolabeling.The DLBCL were classified into germinal center B cell-like ( GCB ) subtypes and non-germinal center B cell-like ( non-GCB) subtypes according to Hans′algorithm.Application of fluorescence in situ hybridization ( FISH ) technique to detect the bcl-6 gene rearrangement.The relationship between CD68, cyclin D1 protein, the bcl-6 gene and the curative effect of chemotherapy and survival was analyzed using statistical software.Respectively by GCB type , non-GCB type immune phenotype and CHOP , R-CHOP chemotherapy group , compare the curative effects.Results 105 patients had GCB 19 cases ( 18.1%) , non-GCB 86 cases ( 81.9%) , CD68 expression was 18 cases ( 17.1%) , cyclin D1 high expression 36 cases ( 34.3%) , bcl-6 gene rearrangement in 21 cases ( 21.9%) , there is no correlation among the three (P>0.05).One-way analysis of variance showed that age ≤60 years, clinical stageⅠ-Ⅱ, IPI score 0 to 2 points, LDH (U/L) <245 IU/L,GCB subtypes,R-CHOP therapy, the prognosis of patients with better (P<0.05), But gender, primary site no correlation with prognosis (P>0.05).CD68,cyclin D1 high expression , bcl-6 rearrangement had poor prognosis ( P <0.05 ).Stratification analysis results show GCB-type or non-GCB type with high expression of CD 68 contrast alloimmune phenotype groups had a poor prognosis,non-GCB type with high expression of cyclin D 1 and rearrangement of bcl-6 gene had a poor prognosis(P<0.001,P=0.02).Treatment scheme of layered display ,the CHOP treatment, significantly correlated with overall survival with high expression of CD 68, cyclin D1 ( P <0.05 ), the R-CHOP treatment, there was no statistically significant difference between CD 68, cyclin D1 high expression and overall survival ( P=0.428 and 0.168 ).Multivariate COX model analysis showed that high expression of CD68 (P=0.026), high expression of cyclin D1 (P=0.003) and high levels of LDH (P=0.005) were adverse prognostic factors independent.Conclusions high expression of CD68, cyclin D1 and rearrangement of bcl-6 gene suggests poor prognosis ,CD68, cyclin D1 protein and bcl-6 gene can be used as a prognostic indicator in patients with DLBCL .
