Abstract
This study investigates the protein expression of C-MYC, BCL-2, and BCL-6 in diffuse large B-cell lymphoma (DLBCL) and their relationship with genetic abnormalities. A retrospective study of 42 cases on paraffin-embedded tissue specimens diagnosed with DLBCL was performed using immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). The expression of C-MYC, BCL-2, BCL-6 protein, and gene abnormalities in these tissue samples was analyzed. The relationship in genetic abnormalities and Ki-67, Hans classification, gender, and age was also evaluated. It was found that the positive rate of C-MYC expression was 47.6% (20/42), the rate of C-MYC gene abnormality was 26.2% (11/42), in which gene translocation accounted for 23.8% (10/42) and gene amplification 2.4% (1/42); C-MYC protein expression was positively correlated with C-MYC gene translocation (χ2 = 11.813; P = 0.001); C-MYC gene translocation was mainly found in germinal center B cell type (χ2 = 4.029; P = 0.045). The positive rate of BCL-2 protein expression was 85.71% (36/42), the positive rate of translocation was 42.86% (18/42) and the amplification rate was 26.19% (11/42); the overexpression of BCL-2 protein was correlated with the BCL-2 translocation (χ2 = 3.407; P = 0.029). The positive rate of BCL-6 protein expression was 45.24% (19/42), the positive rate of BCL-6 translocation was 14.29% (6/42) and the positive rate of BCL-6 amplification was 7.14% (3/42); the overexpression of BCL-6 protein was significantly correlated with BCL-6 translocation (χ2 = 6.091; P = 0.014). The Ki-67 index was significantly higher in C-MYC translocation cases than in non-C-MYC translocation cases (χ2 = 4.492; P = 0.034). Taken together, our results suggest that the protein expression of C-MYC, BCL-2, and BCL-6 are positively correlated with their gene translocation. Overexpression of C-MYC, BCL-2, BCL-6 protein suggests the possibility of translocation. Therefore, immunohistochemical detection of C-MYC, BCL-2, and BCL-6 are useful in diagnosis and prognosis of DLBCL.
Highlights
Diffuse large B-cell lymphoma (DLBCL) is a highly heterogeneous lymphoid hematopoietic malignancy which is one of the most common types of adult non-Hodgkin’s lymphoma (NHL)
BCL-6 and C-MYC positive staining were located in the nucleus, while BCL-2 positive staining was in the cytoplasm (Figure 2)
There was no significant difference in the distribution of C-MYC, BCL-2, and BCL-6 protein expression in Hans classification, gender, and age (Table 1)
Summary
Diffuse large B-cell lymphoma (DLBCL) is a highly heterogeneous lymphoid hematopoietic malignancy which is one of the most common types of adult non-Hodgkin’s lymphoma (NHL). Hans criteria is based on the presence or absence of three biomarkers, CD10, BCL-6, and MUM-1in immunohistochemical staining using antibodies against CD10, IRF4/MUM1, and BCL6. Those with the number of CD10 positive cells greater than 30%, as well as BCL6 positive belong to the germinal center B cell subtype, and the rest are judged as non-germinal center B cell subtype (Hans et al, 2004). Different types of lymphoma have differences in cell morphology, protein expression, genetic changes, and therapeutic responsiveness. Understanding the molecular characteristics of lymphoma are critical for individualized patient care
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