Mechanism and clinical significance of anti-apoptotic gene bcl-2 expression in diffuse large B-cell lymphoma.
- Author:
Li-ping ZENG
1
;
Yi-lei WEN
;
Yun MA
;
Gui-qiu WANG
;
Ying LI
;
Jin WANG
;
Li-li XU
;
Xue-mei ZHANG
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; Child; Child, Preschool; Cyclophosphamide; therapeutic use; Doxorubicin; therapeutic use; Female; Gene Amplification; Gene Expression Regulation, Neoplastic; Genes, bcl-2; Humans; Immunoglobulin Heavy Chains; genetics; In Situ Hybridization, Fluorescence; Lymphoma, Large B-Cell, Diffuse; classification; drug therapy; genetics; metabolism; pathology; Male; Middle Aged; NF-kappa B; metabolism; Prednisone; therapeutic use; Proto-Oncogene Proteins c-bcl-2; genetics; metabolism; Survival Rate; Translocation, Genetic; Vincristine; therapeutic use; Young Adult
- From: Chinese Journal of Pathology 2011;40(6):377-381
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the molecular mechanism and prognostication of bcl-2 protein expression in different subgroups of diffuse large B-cell lymphoma(DLBCL) in Guangxi Zhuang Autonomous Region, China.
METHODSImmunohistochemical stains for CD10, bcl-6, MUM-1, bcl-2 and NF-κB were performed in 214 cases of DLBCL. The Hans immunologic classification was applied to classify DLBCL into GCB and non-GCB subgroups. Using a dual-probe fluorescence in-situ hybridization (FISH) assay, IgH/bcl-2 gene translocation and bcl-2 amplification were analyzed.
RESULTSIn 214 cases of DLBCL, 30.8% (66/214) of cases were GCB and 69.2% (148/214) were non-GCB. Twenty-seven point three percent (18/66) of GCB subgroups and 59.5% (88/148) of non-GCB subgroups had bcl-2 protein expression, with a significant difference (P < 0.01). IgH/bcl-2 translocation was positive in 3.7% (8/214) of cases, even majority of them (6/8) was found in GCB subgroup, while represented only 9.1% of GCB case. There was a significant difference (P = 0.02) in bcl-2 gene amplification between GCB (27/66, 40.9%) and non-GCB subgroup (86/148, 58.1%). Among non-GCB cases, the expression of bcl-2 was correlated with that of NF-κB expression and bcl-2 gene amplification (r = 0.216 and 0.219, respectively, P < 0.05). No similar correlation was observed in GCB cases. The overall survival time of bcl-2-positive patients (31.4 ± 3.8) months was shorter than that of bcl-2-negative patients (40.2 ± 4.2) months. In conjunction with immunophenotypes and clinical stages, the bcl-2 positive patients had a 1.89 times higher risk than that of the bcl-2 negative patients.
CONCLUSIONSMajority of the cases were prognostically unfavorable non-GCB subgroups among DLBCL, which were characterized by high frequency of bcl-2 gene amplification and low frequency of IgH/bcl-2 translocation. The anti-apoptotic gene bcl-2 was frequently expressed in non-GCB subgroups and closely related to the gene amplification and NF-κB activation. bcl-2 positive patients had more short overall survival times, would face significant higher risk of death, these results suggested that bcl-2 could be a prognostic marker independent to clinical staging and immunophenotyping.
