Characteristics of CD5-positive diffuse large B-cell lymphoma among Koreans: High incidence of BCL2 and MYC double-expressors


Autoři: Hee Young Na aff001;  Ji-Young Choe aff002;  Sun Ah Shin aff002;  Hyun-Jung Kim aff005;  Jae Ho Han aff006;  Hee Kyung Kim aff007;  So Hee Oh aff008;  Ji Eun Kim aff002
Působiště autorů: Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea aff001;  Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea aff002;  Department of Pathology, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi, Republic of Korea aff003;  Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea aff004;  Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea aff005;  Department of Pathology, Ajou University School of Medicine, Suwon, Geonggi, Republic of Korea aff006;  Department of Pathology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea aff007;  Department of Biostatistics, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea aff008;  Department of Pathology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea aff009
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224247

Souhrn

Aberrant expression of CD5 has been reported in 5–10% of diffuse large B-cell lymphomas (DLBCLs). CD5+ DLBCL had been recognized as an aggressive immunophenotypic subgroup of DLBCL in the 2008 WHO classification of haematolymphoid neoplasm; however, it was eliminated from the list of subgroups of DLBCLs in the revised 2016 classification. Nevertheless, there is much controversy regarding the clinical significance of CD5 expression, and many researchers still assert that this subgroup exhibits an extremely unfavorable prognosis with frequent treatment failure. We retrospectively investigated 405 DLBCLs recruited from three university hospitals in Korea from 1997 to 2013. The clinical profile, immunophenotype, and chromosomal structural alterations of the BCL2 and MYC genes were compared according to CD5 expression. A total of 29 cases of de novo CD5+ DLBCL were identified out of 405 in our series (7.4%). Clinicopathologic correlation was performed in all 29 CD5+ DLBCLs and 166 CD5- DLBCLs which were eligible for full clinical review and further pathologic examination. Compared with CD5- counterparts, CD5+ DLBCLs showed female preponderance, frequent bone marrow involvement, higher lactate dehydrogenase level, advanced Ann Arbor stages and poorer prognosis (all p<0.05). Pathologically, the expression of CD5 positively correlated with that of BCL2, MYC and Ki-67 (all p<0.05). Coexpression of BCL2 and MYC, which is referred to as a double-expressor, was relatively more common in CD5+ DLBCL, whereas translocation or amplification of these genes was very rare. in conclusion, the expression of CD5 is an independent poor prognostic factor of DLBCLs, and this subgroup displays unique clinicopathologic features. Although the exact mechanism remains uncertain, consistent activation of BCL2 and MYC by alternative pathways other than chromosomal translocation may contribute to the pathogenesis.

Klíčová slova:

B cells – Cancer treatment – Immunohistochemistry techniques – Korea – Lymphomas – Prognosis – Diffuse large B-cell lymphoma – Korean people


Zdroje

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2019 Číslo 10