Expression of transmembrane adaptor protein PAG/Cbp in diffuse large B-cell lymphoma: immunohistochemical study of 73 cases

PAG/Cbp is a transmembrane adaptor protein involved in proximal immune signaling. It is expressed in reactive germinal centers (GC) of secondary lymphatic follicles and related malignant lymphomas. We studied PAG/Cbp expression in GC-like and non-GC-like diffuse large B-cell lymphoma (DLBCL) subtypes. Seventy-three cases of DLBCL identified among 155 malignant lymphomas were classified as GC-like DLBCL (CD10+ or CD10-, bcl-6+, and MUM1-) and non-GC-like DLBCL (CD10-, MUM1+ or CD10-, bcl-6+, MUM1+). PAG/Cbp was detected by monoclonal antibody MEM-255 following routine immunohistochemical procedures. Thirty-five of 40 GC-like DLBCLs (88%) and 20 of 33 non-GC-like DLBCL cases (61%) expressed PAG/Cbp. Four of 12 bcl-6-negative non-GC-like DLBCL cases (33%) were PAG/Cbp positive, and only 4 of 20 bcl-6-positive non-GC-like DLBCL cases (25%) were PAG/CBP negative. All 37 FL and all 5 Burkitt's lymphomas (BL) expressed PAG/Cbp, whereas all 6 mantle cell lymphomas (MCL) and 4 of 5 chronic lymphocytic leukemias (CLL/SLL) were PAG/Cbp negative. PAG/Cbp is a reliable GC marker. Its expression correlates with GC-like DLBC phenotype in a significant majority of cases. It is typically absent in MCL and SLL/CLL.     

IL-6和AG490对移植裸鼠的弥漫大B细胞淋巴瘤和伯基特淋巴瘤生长的影响

目的:观察STAT3通路对移植裸鼠弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)和伯基特淋巴瘤(Burkitt lymphoma,BL)的作用。方法:建立OCI-LY8细胞(DLBCL)和Raji细胞(BL)裸鼠移植瘤模型,并分别将其分为对照组、IL-6组和AG490组,测量裸鼠体重和肿瘤体积;应用Western blot和免疫组织化学检测移植瘤组织中p-STAT3、survivin及血管内皮生长因子(VEGF)蛋白的水平;real-time PCR检测瘤组织中survivin和VEGF的mRNA表达。结果:2种细胞株总成瘤率为83.3%(25/30),其中OCI-LY8细胞成瘤率为66.7%(10/15),低于Raji细胞成瘤率100%(15/15)(P0.05)。DLBCL和BL荷瘤鼠IL-6组在第9和10天裸鼠体重和总瘤体积较对照组均增加,2种移植瘤的IL-6组中第1天与第10天瘤体积总差值均明显大于对照组(P0.05)。pSTAT3阳性信号定位于细胞核;survivin和VEGF以细胞浆表达为阳性。与对照组相比,DLBCL移植瘤IL-6组survivin和VEGF明显升高(P0.05),p-STAT3无显著变化;AG490组p-STAT3及VEGF明显降低(P0.05),survivin无显著变化;在BL移植瘤IL-6组,p-STAT3和VEGF蛋白与相应对照相比均显著升高(P0.05),在AG490处理组中3种蛋白均明显降低(P0.05)。IL-6组和AG490组中survivin和VEGF的mRNA表达与对照组相比差异无统计学显著性。结论:IL-6和AG490可能通过STAT3通路影响DLBCL和BL的生长,STAT3通路活化可能通过调控VEGF和survivin表达而影响肿瘤的发生发展。     

SNS-032诱导弥漫性大B淋巴瘤OCI-LY-19细胞株凋亡及其作用机制的研究

 目的： 研究SNS-032对弥漫性大B淋巴瘤细胞株OCI-LY-19凋亡的影响并探讨其作用机制。方法：应用MTS法观察不同浓度的SNS-032对OCI-LY-19细胞活力的影响;用PI单染法观察SNS-032对OCI-LY-19细胞诱导死亡的影响;Annexin V/PI双染流式细胞术分析不同浓度SNS-032对OCI-LY-19细胞凋亡的影响;Western blotting检测细胞凋亡相关蛋白和细胞增殖相关蛋白的表达情况。结果：SNS-032明显抑制OCI-LY-19细胞活力,半数抑制浓度为0.358 μmol/L;随SNS-032作用时间延长与浓度升高,凋亡细胞数逐渐增多;SNS-032可以时间与剂量依赖性地引起凋亡相关蛋白聚腺苷二磷酸-核糖聚合酶(PARP)的切割,caspase-3前体(procaspase-3)、caspase-9前体(procaspase-9)、X连锁凋亡抑制蛋白(XIAP)与髓样细胞白血病1(Mcl-1)的表达下降,而cleaved caspase-3和cleaved caspase-9表达明显增加;与细胞增殖相关的蛋白丝/苏氨酸激酶(Akt)、磷酸化Akt(p-Akt)、信号转导子及转录激活子5 (STAT5)、磷酸化STAT5（p-STAT5）、细胞外信号调节激酶(ERK)和磷酸化ERK(p-ERK)表达下降,而ERK总蛋白无明显变化。结论：SNS-032能抑制弥漫性大B淋巴瘤细胞株OCI-LY-19的生长,诱导其凋亡,可能的机制是抑制了相关抗凋亡蛋白的表达,激活了caspase级联反应,同时抑制了与细胞增殖相关的JAKs/STATs、MEK/ERK和PI3K-Akt信号转导通路的表达与活化。     

Comparative clinicopathological study of primary CNS diffuse large B-cell lymphoma and intravascular large B-cell lymphoma

Primary CNS diffuse large B-cell lymphoma (CNS DLBCL) is confined to the CNS, and constitutes a distinct entity. In the present study a series of 40 Japanese patients with CNS DLBCL who presented with neurological, but not systemic symptoms, was reviewed. Median survival was 18.7 months. CD5, CD10, Bcl-6, MUM-1, and Bcl-2 were positive in 30%, 10%, 84%, 100%, and 93% of patients, respectively. All CD10-negative patients had non-germinal center B-cell type. There was no significant difference in survival among the immunophenotypic subgroups. CNS DLBCL appeared to be homogenous as a group, which prompted the comparison with another distinct extranodal entity, intravascular large B-cell lymphoma (IVLBCL) in Japanese patients. CNS DLBCL patients did not differ in age, sex, or immunophenotype, including CD5 positivity, from IVLBCL patients, but were significantly less likely to have poor prognostic parameters than IVLBCL patients: the international prognostic index score was low or low–intermediate in 86% of CNS DLBCL patients and high or high–intermediate in 98% of IVLBCL patients. Notably, despite this difference, their survival curves almost overlapped. The present study highlights the issue of clinical distinctiveness of aggressive extranodal lymphomas, the peculiar migration and localization of which should be further clarified.     

Identification of chromosomal copy number changes associated with transformation of follicular lymphoma to diffuse large B-cell lymphoma

The histological transformation from a follicular lymphoma (FL) to a diffuse large B-cell lymphoma (DLBL) occurs in 22% to 30% of all cases of FL. The aim of this study was to identify specific chromosomal gains/losses associated with transformation of FL to DLBL, in addition to the well-known mechanisms like p53 mutation and protein expression and c-myc translocation and up-regulation. This is the first study to meet 2 important conditions for such a comparison. First, we demonstrate that the FL and the DLBL were clonally related, based on identical immunoglobulin gene rearrangements in 5 of the 6 cases. Second, we used laser microdissection microscopy to isolate only the neoplastic cells from the initial FL samples. The results indicate that no single chromosomal abnormality seems to be responsible for the transformation of FL to DLBL. P53 protein overexpression was found in 4 and c-myc translocation in 3 of the 6 transformed DLBLs, but not in the initial FL samples. Additional chromosomal abnormalities were detected by comparative genomic hybridization in all 6 cases when the DLBL was compared with the FL. In the 5 cases with transformation of grade 1 or 2 FL to DLBL, gains at chromosomes 7 (5 of 5 cases), 10p1 (3 of 5 cases), 12 (3 of 5 cases), and 20p13 (2 of 5 cases) and loss at 9q (4 of 5 cases) were the most frequently found abnormalities. A gain on chromosome 7p, in combination with a loss on 9q, was found in 4 of the 5 DLBL that transformed from FL grade 1 or 2.     

EZH2 expression is dependent on MYC and TP53 regulation in diffuse large B-cell lymphoma

EZH2 is an important epigenetic regulator, but its role in diffuse large B-cell lymphoma (DLBCL) pathogenesis and its relationship with MYC, BCL2, and TP53 expression, chromosomal rearrangements, and clinical features are still poorly understood. So, we investigated EZH2 expression and its associations with the immunophenotypic presentations, including MYC, BCL2, and TP53 expression, MYC, BCL2, and BCL6 translocation status, clinicopathological features, and therapeutic response to R-CHOP in a series of 139 DLBCL cases. EZH2 positivity was associated with MYC and TP53 expression (p = 0.0002 and p = 0.0000, respectively) and to high proliferative index (Ki67>70%, p = 0.0082). No associations were found among EZH2 expression and chromosomal translocation status. The non-germinal center (nGC) DLBCL presented most of associations observed in the general sample; however, only TP53 immunodetection showed associations with EZH2 expression in the germinal center (GC) DLBCL. EZH2 expression had no impact on therapeutic efficacy in R-CHOP-treated patients. In conclusion, EZH2 seems to be upregulated by MYC, to rely on TP53 alterations, and is associated with high proliferative tumors in DLBCL, which might be dependent on GC or nGC subclassifications. Furthermore, it is not a therapeutic efficacy marker to R-CHOP in our series.     

Hsa-miR-150过表达诱导弥漫大B淋巴瘤细胞系OCI-Ly10再分化

 目的:探究hsa-miR-150过表达诱导弥漫大B淋巴瘤细胞系OCI-Ly10再分化的机制。方法:运用real-time PCR检测hsa-miR-150在永生化CD19+B细胞和OCI-Ly10细胞中的表达,利用Western blotting和免疫荧光细胞化学检测hsa-miR-150靶基因c-myb的表达;通过LipofectamineTM 2000脂质体法将含有重组慢病毒质粒的病毒上清转染OCI-Ly10细胞（Ly10-control组和Ly10-miR-150组）;对新构建的细胞亚系,通过MTT法检测细胞增殖能力,流式细胞术检测细胞周期及凋亡;运用real-time PCR、免疫荧光细胞化学和Western blotting检测Ly10-control和Ly10-miR-150的B细胞分化相关基因及c-Myb的表达;利用干扰片段干扰OCI-Ly10细胞c-myb表达后,运用real-time PCR和Western blotting检测干扰效率及干扰后转录调节因子BCL6和浆细胞分化开关蛋白PRDM1的表达。结果:（1）CD19+B淋巴细胞的 hsa-miR-150表达量明显高于OCI-Ly10细胞（P<0.05）;c-Myb在OCI-Ly10细胞中表达较强,而在CD19+B淋巴细胞表达较弱。（2）OCI-Ly10细胞经转染hsa-miR-150后,B细胞分化相关基因的表达都明显发生了变化,B细胞特异性激活蛋白（PAX5）和BCL6表达下调（P<0.05）;干扰素调节因子4（IRF4）、PRDM1和X盒结合蛋白1(XBP1)的表达上调（P<0.05）;和对照组相比,c-Myb在Ly10-miR-150细胞中表达明显下调（P<0.05）。（3）干扰OCI-Ly10细胞c-myb表达后,BCL6表达明显下调,而PRDM1表达明显上调。结论:（1）hsa-miR-150过表达对OCI-Ly10细胞抑制增殖和诱导凋亡作用非常明显。（2）过表达hsa-miR-150可诱导该瘤细胞向末端B细胞方向分化,作用机制可能与下调其靶基因c-myb的表达有关。     

CD3-positive diffuse large B-cell lymphoma relapses as CD3-negative large B-cell lymphoma: Loss of aberrant antigen expression in B-cell lymphoma after chemotherapy

Aberrant expression of CD3 on diffuse large B-cell lymphoma (DLBCL) is rare, and its mechanism and biological significance are currently unclear. Herein we report a case of Epstein-Barr virus-negative, CD3-positive DLBCL in a 53?year-old male, who had a remote history of renal transplantation. After standard chemotherapy, the patient was in clinical remission. He relapsed three years later, but at this time with apparent loss of CD3 expression. PCR-based IGK gene rearrangement studies demonstrated clonal amplicons with an identical nucleotide size between the primary and secondary DLBCL, confirming the clonal relationship despite their phenotypic differences. To our knowledge, this is the first case of CD3-positive DLBCL that demonstrated a loss of aberrant CD3 on relapse. The chronologic change in phenotype seen in this case suggests that the source of the patient’s lymphoma relapse may arise from either a quiescent subclone without CD3 expression, or from an upstream neoplastic precursor cell.     

A malignant lymphoma with histological features and immunophenotypic profile intermediate between EBV-positive diffuse large B-cell lymphoma and EBV-positive classical Hodgkin lymphoma in a 67-year-old female: a "gray zone" lymphoma associated with Epstein-Barr virus in the elderly

Epstein-Barr virus (EBV) can be associated with both classical Hodgkin lymphoma (cHL) and non-Hodgkin lymphoma of the B-cell type, particularly in immunodeficient patients or elderly individuals. While polymorphic variants of EBV-positive large B-cell lymphoma (EBV+ DLBCL) frequently resemble cHL in morphology, and thereby may cause diagnostic difficulty, a true gray zone lymphoma with overlapping morphological and immunophenotypical features of EBV+ DLBCL and EBV+ cHL has not been reported in the literature. We describe a unique case of an EBV+ malignant lymphoma of B-cell origin with hybrid features of EBV+ DLBCL and EBV+ cHL in a 67-year-old female without an identifiable etiology for immunodeficiency. The biopsy of an enlarged lymph node showed a polymorphic infiltrate containing Reed-Sternberg-like pleomorphic large cells, which were positive for CD30 and CD15. Although CD20 was negative and PAX5 and CD45 were down-regulated, the pleomorphic large cells expressed multiple other B-cell antigens which are characteristically absent in cHL. EBV-encoded RNA hybridization (EBER) studies demonstrated nuclear reactivity in the large cells as well as in the smaller bystander cells. A clonal rearrangement of the immunoglobulin heavy chain gene was also detected by PCR. Although the results of the EBV and genotypic studies suggest this case may be an example of EBV+ DLBCL of the elderly instead of EBV+ cHL, the immunophenotype is strikingly ambiguous. Thus, this case may represent an interface between EBV+ DLBCL and EBV+ cHL.     

Expression of Grb2 distinguishes classical Hodgkin lymphomas from primary mediastinal B-cell lymphomas and other diffuse large B-cell lymphomas

Growth factor receptor-bound protein 2 is an adaptor molecule that mediates B-cell receptor (BCR) signaling pathways, but the expression of growth factor receptor-bound protein 2 in lymphoma tissues has not been reported. We sought to characterize growth factor receptor-bound protein 2 protein expression in reactive tonsillar tissues and lymphoma tissues obtained from diagnostic biopsies of classical Hodgkin lymphoma, primary mediastinal large B-cell lymphoma, diffuse large B-cell lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, and 20 low-grade B-cell lymphomas. Growth factor receptor-bound protein 2 expression was assessed in tissues by immunohistochemistry and in lymphoma cell lines by immunoblotting. In reactive lymphoid tissues, growth factor receptor-bound protein 2 was expressed in the cytoplasm of B-cells and histiocytes but not T-cells. Strong, cytoplasmic growth factor receptor-bound protein 2 expression was seen in the neoplastic cells of follicular lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, splenic marginal zone lymphoma, primary mediastinal large B-cell lymphoma, diffuse large B-cell lymphoma, and nodular lymphocyte predominant Hodgkin lymphoma. In contrast, only 10% of the classical Hodgkin lymphomas showed growth factor receptor-bound protein 2 expression in the neoplastic cells. Growth factor receptor-bound protein 2 protein expression was detected by Western blotting in all lymphoma cell lines tested with higher levels in primary mediastinal large B-cell lymphoma compared with classical Hodgkin lymphoma cell lines. These findings support a role for growth factor receptor-bound protein 2 in the diagnostically challenging workup of classical Hodgkin lymphoma versus primary mediastinal large B-cell lymphoma and warrant further studies to evaluate the biologic significance of growth factor receptor-bound protein 2 in the pathogenesis of classical Hodgkin lymphoma.     

Therapeutic comparison of chemotherapy and surgery for early stage diffuse large B-cell gastric lymphoma

PURPOSE: The use of surgery versus stomach-preserving treatment for primary gastric lymphoma has caused controversy among doctors. This retrospective, single center study aims to evaluate the efficacy and benefit of stomach-preserving treatment against surgery for early stage diffuse large B-cell lymphoma of stomach. MATERIALS AND METHODS: From August 1991 to January 2006, 43 cases of early-stage diffuse large B-cell gastric lymphoma were reviewed. RESULTS: Eleven cases were treated with chemotherapy or chemotherapy plus radiation (CT +/- RT), 17 were treated with surgery alone (OP), and 15 were treated with surgery plus adjuvant chemotherapy (OP + CT). The complete remission and response rates were 63.6% and 90.9% in those treated with CT +/- RT (7 complete responders, 3 partial responders, 1 non-responder), 100% and 100% in those treated with OP, and 100% and 100% in those treated with OP + CT, respectively. Five-year overall survival rates were 85.7%, 87.5%, and 100% in those treated by CT +/- RT, OP, and OP + CT, respectively (p=0.76). The five-year disease free survival rates were 100%, 87.5% and 100% in those treated by CT +/- RT, OP, and OP + CT, respectively (p=0.99). There was no significant difference in overall survival and disease free survival between modalities. Even though there are no definite differences in the number of complications between those treated by CT +/- RT or OP, these facts reflect little concern on complications after surgery. CONCLUSION: In preventing morbidity arising from early or late complications from surgery and promoting quality of life, chemotherapy should be a primary consideration for early stage diffuse large B-cell lymphoma of the stomach.     

弥漫性大B细胞淋巴瘤免疫分型与分子遗传学异常的研究

目的 分析弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)的免疫表型分型和分子遗传学异常,并探讨二者之间的相关性及其对于预后的意义.方法 用免疫组织化学链霉亲和素-过氧化物酶法检测59例DLBCL患者中CD10、BCL6、MUM1的表达,采用Hans免疫分型法将DLBCL分为生发中心B细胞(germinal center B-cell,GCB)型和非GCB型;分别应用BCL6双色断裂点分离探针、IgH/BCL2双色双融合探针及MYC双色断裂点分离探针在石蜡包埋的淋巴瘤组织切片上进行荧光原位杂交分析,检测BCL6、BCL2和MYC基因的易位和扩增情况.结果 在59例DLBCL患者中,GCB型占28.8％(17/59),非GCB型占71.2％ (42/59).BCL6、BCL2和MYC基因易位的发生率分别为24.1％(14/58)、1.7％(1/59)和5.3％(3/57),BCL6、BCL2和MYC基因扩增的发生率分别为17.2％ (10/58)、22.0％(13/59)和21.1％(12/57).BCL6扩增与BCL6易位无相关性(P=0.424),但与BCL2及MYC扩增呈正相关(列联系数C值分别为0.405和0.403,P值均＜0.01).在GCB型中BCL6易位的发生率高于非GCB型,而BCL6、BCL2或MYC扩增更常见于非GCB型,差异接近但均无统计学意义(P值分别为0.089和0.106).在单因素分析中,免疫分型和国际预后指数积分对总生存率(overall survival,OS)均有显著影响(P值分别为0.047和0.001),而BCL6易位和3基因扩增对OS率均无明显影响(P值分别为0.150和0.444);在多因素分析中,国际预后指数积分是影响OS唯一的独立预后因素(RR=3.843,P=0.017).结论 本组DLBCL患者中GCB亚型较少见,常见的遗传学异常为BCL6易位和BCL6、BCL2及MYC扩增,且3基因扩增之间密切相关,而BCL2易位的发生率低.免疫表型分型对预后的预测意义较小,遗传学异常不能用于预测DLBCL患者的预后.     

弥漫大B细胞淋巴瘤中Prdx6的表达及其预后意义

目的 探讨过氧化物酶6(peroxiredoxin-6,Prdx6)在弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)中的表达及其预后意义.方法 回顾性分析286例DLBCL中Prdx6的表达及与临床病理特征和预后之间的关系.结果 Prdx6在DLBCL中的表达高于正常淋巴结...     

Development of angioimmunoblastic T-cell lymphoma after treatment of diffuse large B-cell lymphoma: a case report and review of literature

Cases of diffuse large B-cell lymphoma (DLBCL) arising after the initial diagnosis of angioimmunoblastic T-cell lymphoma (AITL) and DLBCL synchronous with AITL have been reported. To date, there is no report on the subsequent development of AITL in patients with DLBCL. Here we presented a rare case of AITL developing six months after the initial diagnosis of DLBCL. In order to investigate the clinical and molecular features of patients with AITL and DLBCL, we also reviewed the literature on AITL patients developing DLBCL, and patients with composite AITL and DLBCL.     

Immunohistochemical algorithm alone is not enough for predicting the outcome of patients with diffuse large B-cell lymphoma treated with R-CHOP

Gene expression profiling (GEP), which can divide DLBCL into three groups, is impractical to perform routinely. Although algorithms based on immunohistochemistry (IHC) have been proposed as a surrogate for GEP analysis, the power of them has diminished since rituximab added to the chemotherapy. We assessed the prognostic value of four conventional algorithms and the genes in each and out of algorithm by IHC and fluorescence in situ hybridization in DLBCL patients receiving immunochemotherapy. The results showed that neither single protein within algorithms nor the IHC algorithms themselves had strong prognostic power. Using MYC aberrations (MA) either on the genetic or protein levels, we established a new algorithm called MA that could divide patients into distinct prognostic groups. Patients of MA had much shorter overall survival (OS) and progression-free survival (PFS) than non-MA (2-year OS: 56.9% vs. 98.7%; 2-year PFS: 26.8% vs. 86.9%; P < 0.0001 for both). In conclusions, using additional prognostic markers not associated with cell of origin may accurately predict outcomes of DLBCL. Studies with larger samples should be performed to confirm our algorithm and optimize the prognostic system of DLBCL.     

Clinicopathologic significance of immunophenotypic profiles related to germinal center and activation B-cell differentiation in diffuse large B-cell lymphoma from Chinese patients

Diffuse large B-cell lymphoma (DLBCL) can be subdivided into prognostically significant groups with germinal center B-cell-like (GCB), activated B-cell-like (ABC), and type 3 groups. In this study, tissue microarray slides composed of 163 de novo DLBCLs from Chinese patients were immunostained for CD20, CD10, Bcl-6, MUM1, CD138, Bcl-2, Ki-67, cyclin D3, geminin, and P27(Kip1). One hundred forty-nine of 163 DLBCLs could then be classified into GCB group (pattern A), activated GCB group (pattern B) and activated non-GCB group (pattern C) according to the expression of CD10, Bcl-6, MUM1, and CD138. Of the 149 cases, 40 (26%) showed pattern A expression and were grouped as GCB group, lower than reported frequency of the studies involving mostly Western population. Compared with cases with pattern A, those with pattern B (activated GCB group) and C (activated non-GCB group) more often presented with more aggressive tumors and a shorter survival time. These results indicate that most of DLBCLs from Chinese patients can be classified into prognostically different groups based on the antigenic expression models using a panel of GCB- and ABC-associated markers. Polymerase chain reaction analysis of t(14;18) showed that 11 of 64 cases were t(14;18)-positive, and most (10 of 11) of it occurred in the group with pattern A. The translocation was significantly associated with expression of Bcl-2 protein. The group with pattern B demonstrated more frequent expression of Ki-67, cyclin D3, geminin, and showed higher proliferative activity than the group with pattern A. These findings suggest that high proliferative activity of tumors with pattern B may be associated with aggressive tumor behavior and poor clinical outcome in patients with DLBCL.     

弥漫大B细胞淋巴瘤中CD27的表达及临床意义

目的探讨弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma, DLBCL)中CD27的表达及其临床意义。方法采用免疫组化EnVision法检测143例DLBCL组织中CD27蛋白的表达;应用FISH技术检测DLBCL组织中MYC、BCL-2、BCL-6基因重排情况。结果 143例DLBCL中,CD27蛋白阳性者46例,阳性率为32.2%。CD27阳性组中BCL-2重排阳性率(17.4%)明显高于CD27阴性组(4.1%),差异有统计学意义(P<0.01)。CD27阳性组病死率(30.4%)明显高于CD27阴性组(15.5%),差异有统计学意义(χ²=4.326,P=0.038)。CD27阳性者与阴性者的Kaplan-Meier生存曲线差异有显著性(χ²=4.485,P=0.034),阳性组生存期较短。结论 CD27高表达与DLBCL预后密切相关,可作为临床预后评价的指标之一。     

CD5(-) diffuse large B-cell lymphoma with peculiar cyclin D1+ phenotype. Pathologic and molecular characterization of a single case

Increased expression of cyclin D1 is notoriously associated with mantle cell lymphoma because of translocation t(11;14)(q13;q32) or variants involving the cyclin D1 gene. We present an unusual case of CD5-negative diffuse large B-cell lymphoma expressing cyclin D1 in the absence of translocation by fluorescence in situ hybridization analysis. Using array-comparative genomic hybridization, we found a complex karyotype without the characteristic chromosomal aberrations accompanying cyclin D1 translocation in mantle cell lymphoma; instead, there was monoallelic deletion of AKT interacting protein and glycogen synthase kinase-3 β genes, both involved in the AKT/glycogen synthase kinase-3 β cascade-controlling nuclear levels of cyclin D1. These findings suggest that posttranslational events regulating cyclin D1 activity may take place also in a subset of diffuse large B-cell lymphomas and contribute to lymphomagenesis. As a consequence, the sole cyclin D1 positivity by immunohistochemistry may not be enough to distinguish pleomorphic/blastoid mantle cell lymphoma from diffuse large B-cell lymphoma. Search for t(11;14) with fluorescence in situ hybridization probes should always be performed in doubtful cases.