Abstract
BackgroundB-cell activation factor (BAFF) and BAFF-receptor (BAFF-R) play crucial roles in the viability and proliferation of malignant lymphoma cells. Limited information exists regarding expression profiles and the prognostic role of BAFF and BAFF-R in follicular lymphoma (FL). We sought to determine the expression profiles of BAFF and BAFF-R in FL and to evaluate the correlation of BAFF and BAFF-R expression with clinicopathologic characteristics and outcome of FL. Correlation between expression levels of BAFF detected by immunohistochemical (IHC) and serum levels of BAFF was also evaluated.MethodsParaffin-embedded specimens from 115 patients were immunohistochemically examined for BAFF and BAFF-R expression. Expression levels were dichotomized into low versus high categories based on immunostaining intensity. The correlation of BAFF and BAFF-R expression with clinicopathologic characteristics and patient outcome was assessed. Serum levels of BAFF in 35 of the 115 patients with IHC data were measured by Enzyme-linked Immunosorbent assay (ELISA).ResultsBAFF and BAFF-R were expressed in 88.7% (102/115) and 87.8% (101/115) of the cases, respectively. BAFF expression was significantly correlated with only one clinicopathologic feature: Ann Arbor stage. No significant correlation was found between expression levels of BAFF detected by IHC and serum levels of BAFF detected by ELISA. High expression of BAFF-R, but not BAFF, was significantly correlated with inferior progression-free survival (PFS; P = 0.013) and overall survival (OS; P = 0.03). High expression of BAFF-R, bulky disease, and elevated lactate dehydrogenase were correlated with inferior PFS and OS in multivariate analysis. A prognostic scoring system incorporating these 3 risk factors identified 3 distinct prognostic groups with 5-year PFS of 59.4%, 41.9%, and 10.7% and OS of 91.3%, 79.7%, and 45.8%, respectively.ConclusionsMost patients with FL variably express BAFF and BAFF-R. High expression of BAFF-R, but not BAFF, may be an independent risk factor for PFS and OS in FL.
Highlights
Follicular lymphoma (FL) is the second most common lymphoma in western countries, accounting for 22% of newly diagnosed cases [1]
Several prognostic indexes have been established to stratify patients into risk groups, including the widely accepted Follicular Lymphoma International Prognostic Index (FLIPI) and the more recently developed Follicular Lymphoma International Prognostic Index 2 (FLIPI2) [3,4], their value is based on a limited number of clinical and laboratory prognostic factors
No significant correlation between expression levels of BAFF detected by IHC and serum levels of BAFF detected by Enzyme-linked Immunosorbent assay (ELISA) was found by Spearman’s rank correlation test
Summary
Follicular lymphoma (FL) is the second most common lymphoma in western countries, accounting for 22% of newly diagnosed cases [1]. The prognostic value of immunohistochemical markers expressed in FL remains to be determined. BAFF plays critical roles in B-cell homeostasis, viability, and malignant transformation by binding and activating three receptors: BAFF receptor (BAFF-R; known as BR3), transmembrane activator and calcium modulator and cyclophilin ligand interactor (TACI), Characteristics. B-cell activation factor (BAFF) and BAFF-receptor (BAFF-R) play crucial roles in the viability and proliferation of malignant lymphoma cells. Limited information exists regarding expression profiles and the prognostic role of BAFF and BAFF-R in follicular lymphoma (FL). We sought to determine the expression profiles of BAFF and BAFF-R in FL and to evaluate the correlation of BAFF and BAFF-R expression with clinicopathologic characteristics and outcome of FL. Correlation between expression levels of BAFF detected by immunohistochemical (IHC) and serum levels of BAFF was evaluated
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