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弥漫性大B细胞淋巴瘤预后不良指标

2017-11-12 21:22  阅读(34)  评论(0)  分类:淋巴造血系统

Poor Prognostic Indicators in Diffuse Large B-Cell Lymphoma

Clinical

High IPI score*

Morphologic

Immunoblastic or plasmablastic morphology

Immunohistochemical

Lack of germinal-center cell phenotype (CD10, BCL6, LMO2,

  or following various cell-of-origin algorithms)*

Double expression of MYC and BCL2*

CD5 expression 

High proliferation (Ki67) index (controversial)

Lack of CD30 expression

CD43 expression

IRF4/MUM-1 expression

P53 expression

CD44s expression

P14 (ARF) nuclear overexpression

Cyclin D3 expression in 50% of lymphoma cells

Cyclin D2 expression

Protein kinase C-β expression

Lung-resistance protein expression

Survivin expression

Caspase 9 inhibition profile

Lack of HLA-DR expression

Poor tumor-infiltrating T-cell response, especially CD4+ or FOXP3+ T cells

High numbers of granzyme B+ or TIA-1+ tumor-infiltrating T cells

Lack of SPARC+ stromal cells (for ABC subgroup)

ALK expression (ALK+ DLBCL)

Molecular

ABC type on gene-expression profiling*

Low HGAL expression

Low LMO2 expression

Redox signature score

BCL2 gene rearrangement

Lack of BCL6 gene rearrangement

Lack of BCL6 gene mutation

Low level of BCL6 messenger RNA transcripts

Non-IG/BCL6 fusion

MYC gene rearrangement, especially IG/MYC Gain or increased copy number of MYC

TP53 mutation

Lack of hypermethylation of O6-methylguanine DNA methyltransferase promoter

Gains involving chromosome region 3p11-p12

注:*Most important factors.

ABC, activated B cell; 

ALK, anaplastic lymphoma kinase; 

IPI, International Prognostic Index.

参考文献:Hematopathology,2e,2016.

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