Evaluation of MYC protein expression using immunohistochemistry in extranodal Diffuse large B-cell lymphoma

DOI IR Open Access
  • Sasaki Yohei
    Department of Medicine, Division of Hematology, Showa University School of Medicine
  • Hattori Norimichi
    Department of Medicine, Division of Hematology, Showa University School of Medicine
  • Uesugi Yuka
    Department of Medicine, Division of Hematology, Showa University School of Medicine
  • Nakata Ayaka
    Department of Medicine, Division of Hematology, Showa University School of Medicine
  • Shimada Shotaro
    Department of Medicine, Division of Hematology, Showa University School of Medicine
  • Watanuki Megumi
    Department of Medicine, Division of Hematology, Showa University School of Medicine
  • Fujiwara Shun
    Department of Medicine, Division of Hematology, Showa University School of Medicine
  • Arai Nana
    Department of Medicine, Division of Hematology, Showa University School of Medicine
  • Uto Yui
    Department of Medicine, Division of Hematology, Showa University School of Medicine
  • Murai So
    Department of Pathology and Laboratory Medicine, Showa University School of Medicine
  • Shiozawa Eisuke
    Department of Pathology and Laboratory Medicine, Showa University School of Medicine
  • Yamochi Toshiko
    Department of Pathology and Laboratory Medicine, Showa University School of Medicine
  • Nakamaki Tsuyoshi
    Department of Medicine, Division of Hematology, Showa University School of Medicine

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Other Title
  • 節外性びまん性大細胞型B細胞リンパ腫における免疫組織化学染色によるMYC蛋白発現の検討

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Abstract

Diffuse large B-cell lymphoma （DLBCL） is the most common B-cell lymphoma. Extranodal DLBCL has a primary site, except for the lymph node, which accounts for 30％ of DLBCL and needs risk stratification for treatment planning. In 63 extranodal DLBCL patients, MYC protein expression was analyzed using immunohistochemistry and compared with the clinical features of those patients to construct a stratified treatment for extranodal DLBCL. The results revealed that ＞40％ of MYC-positive cells were defined as high MYC protein expression, and ＜40％ of MYC-positive cells were defined as low MYC protein expression. The most frequent extranodal sites were the pharynx or tonsils, followed by the stomach. MYC protein expression occurred in 21 （33％） patients. The pleura was a significantly more common site for extranodal DLBCL with high MYC protein expression at the primary sites than for DLBCL with low MYC protein expression （p＝0.042）. Patients with high MYC protein expression exhibited significantly higher stage and international prognostic index and shorter overall survival than other patients （p＜0.0010, p＜0.0010, and p＝0.0017, respectively）. The percentage of MYC-positive cells was correlated with increased serum lactate dehydrogenase （r＝0.30, p＝0.019） and significantly associated with increased international prognostic index （p＝0.020）. We suggest that MYC protein expression is the prognostic marker in extranodal DLBCL.

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