Clinical Significance of BCL2 , C- MYC , and BCL6 Genetic Abnormalities, Epstein-Barr Virus Infection, CD5 Protein Expression, Germinal Center B Cell/Non-Germinal Center B-Cell Subtypes, Co-expression of MYC/BCL2 Proteins and Co-expression of MYC/BCL2/BCL6 Proteins in Diffuse Large B-Cell Lymphoma: A Clinical and Pathological Correlation Study of 120 Patients

Clinical significance of germinal center B-cell (GCB) and non-GCB sub-categorization, expression of MYC, BCL2, BCL6, CD5 proteins and Epstein Barr virus encoded RNA (EBER) positivity in diffuse large B-cell lymphoma (DLBCL) remain controversial. Could these biomarkers accurately identify high risk D...

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Published in:International journal of medical sciences 2019-01, Vol.16 (4), p.556-566
Main Authors: Ting, Choo-Yuen, Chang, Kian-Meng, Kuan, Jew-Win, Sathar, Jameela, Chew, Lee-Ping, Wong, Oy-Leng Jacqueline, Yusuf, Yusri, Wong, Lily, Samsudin, Ahmad Toha, Pana, Mohd Nurjaya Bin Mohd, Lee, Suk-Kam, Gopal, Navarasi S Raja, Puri, Rita, Ong, Tee-Chuan, Bahari, Samsol Kamal, Goh, Ai-Sim, Teoh, Ching-Soon
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Language:English
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Summary:Clinical significance of germinal center B-cell (GCB) and non-GCB sub-categorization, expression of MYC, BCL2, BCL6, CD5 proteins and Epstein Barr virus encoded RNA (EBER) positivity in diffuse large B-cell lymphoma (DLBCL) remain controversial. Could these biomarkers accurately identify high risk DLBCL patients? Are MYC, BCL2 and BCL6 proteins expression feasible as baseline testing to predict , or gene rearrangements? To investigate prognostic values of GCB/non-GCB sub-categorization, Double Protein Expression Lymphoma (DPL), Triple Protein Expression Lymphoma (TPL), positivity of CD5 protein and EBER in patients with DLBCL disease. To evaluate correlation between , and gene rearrangements with BCL2, MYC and BCL6 proteins expression. Diagnostic tissue samples of 120 DLBCL patients between January 2012 to December 2013 from four major hospitals in Malaysia were selected. Samples were subjected to immunohistochemical staining, fluorescent in-situ hybridization (FISH) testing, and central pathological review. Pathological data were correlated with clinical characteristics and treatment outcome. A total of 120 cases were analysed. Mean age of diagnosis was 54.1 years ± 14.6, 64 were males, 56 were females, mean follow up period was 25 months (ranged from 1 to 36 months). Of the 120 cases, 74.2% were non-GCB whereas 25.8% were GCB, 6.7% were EBER positive, 6.7% expressed CD5 protein, 13.3% were DPL and 40% were TPL. The prevalence of c , gene rearrangements were 5.8%, 5.8%, and 14.2%, respectively; and 1.6% were Double Hit Lymphoma (DHL). EBER positivity, DPL, TPL, c gene rearrangement, gene rearrangement, extra copies of gene and gene rearrangement were associated with shorter median overall survival (P0.05). Fluorescent hybridization is the preferred technique for prediction of treatment outcome in DLBCL patients. , , and gene rearrangements, EBER expression, DHL, TPL and IPI score are reliable risk stratification tools. MYC, BCL2 and BCL6 proteins expression are not applicable as baseline biomarkers to predict , , and gene rearrangements.
ISSN:1449-1907
1449-1907
DOI:10.7150/ijms.27610