J Korean Med Sci.  2006 Jun;21(3):397-405. 10.3346/jkms.2006.21.3.397.

Prognostic Evaluation of Nodal Diffuse Large B Cell Lymphoma by Immunohistochemical Profiles with Emphasis on CD138 Expression as a Poor Prognostic Factor

• Oh YH
• Park CK

• KMID: 1778418
• DOI: http://doi.org/10.3346/jkms.2006.21.3.397

Abstract

Recently diffuse large B cell lymphoma (DLBCLs) was reported to be subdivided into germinal center B-cell-like (GCB) and activated B-cell-like (ABC) subgroups by using cDNA microarray and immunohistochemical markers. Tissue microarray blocks were created from 51 nodal DLBCLs with control tissue. Immunohistochemical staining for the above markers were performed. The median follow-up period was 26 months. Nodal DLBCLs were subclassified into GCB [CD10+ or CD10-/Bcl-6+/MUM1-, n=17 (33%)] and non-GC subgroups [CD10-/Bcl-6- or CD10-/Bcl-6+/MUM1+, n=35 (67%)], and were alternatively subclassified into pattern A [+ for GCB marker only, n=12 (23%)], B [Co-positive for both markers, n=13 (33%)], C [+ for activation marker only, n=18 (35%)], and D [- for both markers, n=9 (17%)]. Upon survival analysis, the GCB groups showed a relatively better survival than non-GC groups (p=0.0748). Also, pattern C (p=0.0055) and CD138+ (p=0.0008) patients had significantly lower survival rates. By multivariate analysis, CD138 expression alone was considered as an independent risk factor (p=0.031). In summary, our results add to the registration of prognostic implications for previously reported DLBCL subgroups. CD138 may play an important role as a poor prognostic marker. By using immunohistochemistry, a prognostically important subclassification of DLBCLs is possible.

Keyword

Lymphoma, Large-Cell, Diffuse; syndecans; CD138; Neprilysin; CD10; DCL-6; MNM-1; Immunohistochemistry; Prognosis

MeSH Terms

Tumor Markers, Biological/metabolism
Syndecans/metabolism
Syndecan-1/*biosynthesis
Prognosis
Neprilysin/biosynthesis
Middle Aged
Male
Lymphoma, Large-Cell, Diffuse/*diagnosis/*metabolism/pathology
Lymphoma, B-Cell/*diagnosis/*metabolism/pathology
Humans
*Gene Expression Regulation, Neoplastic
Female
Aged, 80 and over
Aged
Adult

Figure

• 

  Fig. 1 Kaplan-Meier survival analysis in DLBCL according to CD10 (A) and Bcl-6 expression (B). (A) Patients with CD10 expression above 30% demonstrate significantly better survival. (B) Patients with Bcl-6 expression above 30% tend to have a relatively better survival, but not at a significant level.

• 

  Fig. 2 Kaplan-Meier survival analysis in DLBCL according to MUM1 (A) and CD138 expression (B). (A) MUM1 expresssion does not influence the overall survival between positive and negative groups. (B) Patients with CD138 expression show a strikingly worse overall survival, although there were only eight positive cases.

• 

  Fig. 3 Kaplan-Meier survival analysis in DLBCL between GCB and non-GC subgroups. (A) The GCB subgroup demonstrates a longer survival than the non-GC subgroup. (B, C) When separately considering patients with low or high IPI scores, the GCB groups possess a longer survival in both low (B) and high IPI score groups (C).

• 

  Fig. 4 Kaplan-Meier survival analysis in DLBCL among patterns A, B, and C. (A) The overall survival rate curve of pattern C shows a significantly lower survival rate compared to patterns A and B. (B, C) When separately considering those patients with low or high IPI scores, pattern C also shows a strikingly poor survival rate in both low (B) and high IPI score groups (C).

• 

  Fig. 5 Histologic and immunohistochemical findings of an 80-yr-old male CD138 positive patient (case 1). (A) Histologic findings of DLBCL patient 1. (B, C, D, E) Tumor cells were diffusely positive for CD138 (B: ×40, C: ×200), CD10 (D: ×200), and BCL-6 (E: ×200). This patient died within six months.

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