Imunohistokemijski algoritmi subklasifikacije difuznog B-velikostaničnog limfoma Immunohistochemical algorithms for diffuse large B cell lymphoma subclassification

摘要

Diffuse large B cell lymphoma, not otherwise specified (DLBCL-NOS) is a heterogenous group of aggressive non-Hodgkin lymphomas for which new molecular and immunohistochemical prognostic parameters are needed. This study included 107 patients with DLBCL-NOS stratified into GCB and non-GCB/ABC subgroup according to the immunohistochemical algorithms proposed by Hans et al. and Choi et al. with a purpose to analyse their prognostic value and correlation to other prognostic parameters. Patients in the non-GCB group according to the Hans' algorithm had significantly shorter event free survival, higher frequency of relapse and unfavorable outcome. No prognostic significance was observed after subclassification according to the Choi's algorithm. These results imply that in the observed patient group immunohistochemical subclassification according to the Hans' algorithm offers better prognostic information than Choi's algorithm.udThis study was also undertaken to test the prognostic significance of CD5 and CD43 markers, as well as c-MYC translocation in DLBCL. Also, the distribution of CD5 and CD43 expression in the GCB and non-GCB/ABC groups was analyzed according to both algorithms. There was no significant correlation between CD5 and CD43 expression and survival, response to therapy or outcome. Prognostic significance of c-MYC translocation could not be analyzed because the incidence of c-MYC translocation in this group of patients was lower than expected. udAlthough the correlation between CD5 and CD43 expression and non-GCB/ABC subgroup did not reach statistical significance, both markers were more frequently distributed in the non-GCB/ABC subgroup. Abberant expression of these markers in tumor cells, as well as correlation between CD43 expression and lack of BCL6 and GCET1 in tumor cells implicates a role these proteins might have in the oncogenesis of the more aggressive form of disease. The study gives a new insight into DLBCL pathogenesis and demonstrates the practical problems in the application of immunohistochemical algorithms in the routine clinical practice.ud