Cargando…
MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system
BACKGROUND: Primary diffuse large B-cell lymphoma of the central nervous system (PCNS-DLBCL) is a distinct clinicopathological entity with a poor prognosis. Concurrent MYC and BCL2 overexpression predicts inferior prognosis in systemic DLBCLs. However, the prognostic significance of MYC and BCL2 in...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4903010/ https://www.ncbi.nlm.nih.gov/pubmed/27286976 http://dx.doi.org/10.1186/s12885-016-2397-8 |
_version_ | 1782437063175438336 |
---|---|
author | Kim, Sehui Nam, Soo Jeong Kwon, Dohee Kim, Hannah Lee, Eunyoung Kim, Tae Min Heo, Dae Seog Park, Sung Hye Kim, Chul Woo Jeon, Yoon Kyung |
author_facet | Kim, Sehui Nam, Soo Jeong Kwon, Dohee Kim, Hannah Lee, Eunyoung Kim, Tae Min Heo, Dae Seog Park, Sung Hye Kim, Chul Woo Jeon, Yoon Kyung |
author_sort | Kim, Sehui |
collection | PubMed |
description | BACKGROUND: Primary diffuse large B-cell lymphoma of the central nervous system (PCNS-DLBCL) is a distinct clinicopathological entity with a poor prognosis. Concurrent MYC and BCL2 overexpression predicts inferior prognosis in systemic DLBCLs. However, the prognostic significance of MYC and BCL2 in PCNS-DLBCL remains elusive. METHODS: Immunohistochemistry (IHC) of MYC, BCL2 and BCL6 was performed on tumor samples from 114 patients with PCNS-DLBCL. IHC score was assigned based on the proportion of immunostained cells. RESULTS: MYC, BCL2, and BCL6 IHC scores were 18.16 ± 19.58, 58.86 ± 35.07, and 39.39 ± 37.66 % (mean ± SD), respectively. Twenty-one cases (18.1 %) were designated as MYC-positive with a cutoff score of 40. BCL2 positivity was found in 87 cases (75.0 %) using a cutoff score of 30. MSKCC (Memorial Sloan-Kettering Cancer Center prognostic model) class 2 and 3 had higher rates of MYC and/or BCL2 positivity (MYC, P = 0.012; BCL2, P = 0.008; dual-positive, P = 0.022). Poor KPS (Karnofsky Performance Status score <70), multifocal disease, Nottingham-Barcelona score ≥2, and MSKCC class 2 and 3 were related to shorter progression-free survival (PFS) (P = 0.001, 0.037, 0.001, and 0.008, respectively). Patients with older age (>60 years) showed poorer overall survival (OS) (P = 0.020). MYC positivity was associated with poor PFS (P = 0.027), while patients with BCL2 positivity exhibited a shorter OS (P = 0.010). Concomitant MYC and BCL2 positivity was related to poor PFS (P = 0.041), while the lack of both MYC and BCL2 expression was related to prolonged OS (P = 0.014). MYC and BCL2 expression had no independent prognostic implication by multivariate analysis in overall patients with PCNS-DLBCL. However, among patients treated with combined high-dose methotrexate, vincristine and procarbazine and radiotherapy, dual MYC and BCL2 overexpression (a cutoff score of 60) was an independent poor prognostic indicator (P = 0.010). CONCLUSIONS: Evaluation of MYC and BCL2 expression may be helpful for the determination of PCNS-DLBCL prognosis. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12885-016-2397-8) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4903010 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-49030102016-06-12 MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system Kim, Sehui Nam, Soo Jeong Kwon, Dohee Kim, Hannah Lee, Eunyoung Kim, Tae Min Heo, Dae Seog Park, Sung Hye Kim, Chul Woo Jeon, Yoon Kyung BMC Cancer Research Article BACKGROUND: Primary diffuse large B-cell lymphoma of the central nervous system (PCNS-DLBCL) is a distinct clinicopathological entity with a poor prognosis. Concurrent MYC and BCL2 overexpression predicts inferior prognosis in systemic DLBCLs. However, the prognostic significance of MYC and BCL2 in PCNS-DLBCL remains elusive. METHODS: Immunohistochemistry (IHC) of MYC, BCL2 and BCL6 was performed on tumor samples from 114 patients with PCNS-DLBCL. IHC score was assigned based on the proportion of immunostained cells. RESULTS: MYC, BCL2, and BCL6 IHC scores were 18.16 ± 19.58, 58.86 ± 35.07, and 39.39 ± 37.66 % (mean ± SD), respectively. Twenty-one cases (18.1 %) were designated as MYC-positive with a cutoff score of 40. BCL2 positivity was found in 87 cases (75.0 %) using a cutoff score of 30. MSKCC (Memorial Sloan-Kettering Cancer Center prognostic model) class 2 and 3 had higher rates of MYC and/or BCL2 positivity (MYC, P = 0.012; BCL2, P = 0.008; dual-positive, P = 0.022). Poor KPS (Karnofsky Performance Status score <70), multifocal disease, Nottingham-Barcelona score ≥2, and MSKCC class 2 and 3 were related to shorter progression-free survival (PFS) (P = 0.001, 0.037, 0.001, and 0.008, respectively). Patients with older age (>60 years) showed poorer overall survival (OS) (P = 0.020). MYC positivity was associated with poor PFS (P = 0.027), while patients with BCL2 positivity exhibited a shorter OS (P = 0.010). Concomitant MYC and BCL2 positivity was related to poor PFS (P = 0.041), while the lack of both MYC and BCL2 expression was related to prolonged OS (P = 0.014). MYC and BCL2 expression had no independent prognostic implication by multivariate analysis in overall patients with PCNS-DLBCL. However, among patients treated with combined high-dose methotrexate, vincristine and procarbazine and radiotherapy, dual MYC and BCL2 overexpression (a cutoff score of 60) was an independent poor prognostic indicator (P = 0.010). CONCLUSIONS: Evaluation of MYC and BCL2 expression may be helpful for the determination of PCNS-DLBCL prognosis. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12885-016-2397-8) contains supplementary material, which is available to authorized users. BioMed Central 2016-06-10 /pmc/articles/PMC4903010/ /pubmed/27286976 http://dx.doi.org/10.1186/s12885-016-2397-8 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Kim, Sehui Nam, Soo Jeong Kwon, Dohee Kim, Hannah Lee, Eunyoung Kim, Tae Min Heo, Dae Seog Park, Sung Hye Kim, Chul Woo Jeon, Yoon Kyung MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system |
title | MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system |
title_full | MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system |
title_fullStr | MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system |
title_full_unstemmed | MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system |
title_short | MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system |
title_sort | myc and bcl2 overexpression is associated with a higher class of memorial sloan-kettering cancer center prognostic model and poor clinical outcome in primary diffuse large b-cell lymphoma of the central nervous system |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4903010/ https://www.ncbi.nlm.nih.gov/pubmed/27286976 http://dx.doi.org/10.1186/s12885-016-2397-8 |
work_keys_str_mv | AT kimsehui mycandbcl2overexpressionisassociatedwithahigherclassofmemorialsloanketteringcancercenterprognosticmodelandpoorclinicaloutcomeinprimarydiffuselargebcelllymphomaofthecentralnervoussystem AT namsoojeong mycandbcl2overexpressionisassociatedwithahigherclassofmemorialsloanketteringcancercenterprognosticmodelandpoorclinicaloutcomeinprimarydiffuselargebcelllymphomaofthecentralnervoussystem AT kwondohee mycandbcl2overexpressionisassociatedwithahigherclassofmemorialsloanketteringcancercenterprognosticmodelandpoorclinicaloutcomeinprimarydiffuselargebcelllymphomaofthecentralnervoussystem AT kimhannah mycandbcl2overexpressionisassociatedwithahigherclassofmemorialsloanketteringcancercenterprognosticmodelandpoorclinicaloutcomeinprimarydiffuselargebcelllymphomaofthecentralnervoussystem AT leeeunyoung mycandbcl2overexpressionisassociatedwithahigherclassofmemorialsloanketteringcancercenterprognosticmodelandpoorclinicaloutcomeinprimarydiffuselargebcelllymphomaofthecentralnervoussystem AT kimtaemin mycandbcl2overexpressionisassociatedwithahigherclassofmemorialsloanketteringcancercenterprognosticmodelandpoorclinicaloutcomeinprimarydiffuselargebcelllymphomaofthecentralnervoussystem AT heodaeseog mycandbcl2overexpressionisassociatedwithahigherclassofmemorialsloanketteringcancercenterprognosticmodelandpoorclinicaloutcomeinprimarydiffuselargebcelllymphomaofthecentralnervoussystem AT parksunghye mycandbcl2overexpressionisassociatedwithahigherclassofmemorialsloanketteringcancercenterprognosticmodelandpoorclinicaloutcomeinprimarydiffuselargebcelllymphomaofthecentralnervoussystem AT kimchulwoo mycandbcl2overexpressionisassociatedwithahigherclassofmemorialsloanketteringcancercenterprognosticmodelandpoorclinicaloutcomeinprimarydiffuselargebcelllymphomaofthecentralnervoussystem AT jeonyoonkyung mycandbcl2overexpressionisassociatedwithahigherclassofmemorialsloanketteringcancercenterprognosticmodelandpoorclinicaloutcomeinprimarydiffuselargebcelllymphomaofthecentralnervoussystem |