Association of SOX11 gene expression withclinical features and prognosis of mantle cell lymphoma.

OBJECTIVE: To study the expression of SOX11 in the patients with mantle cell lymphoma (MCL) and explore the clinical values of SOX11 in MCL. PATIENTS AND METHODS: In the paraffin-embedded MCL tissues of 75 patients diagnosed in the Department of Hematology, Shanxi Tumor Hospital, were performed the immunohistochemical labeling of Ki67 and SOX11 by the EnVision method. Meanwhile, the expression of SOX11 mRNA was also detected by reverse transcriptase-polymerase chain reaction (RT-PCR), and the association of SOX11 with such prognostic indexes as pathological typing, staging, immunophenotyping, and MIPI was analyzed using the statistical method. RESULTS: The immunohistochemistry showed that 97% of cases expressed SOX11 positive, and the RT-PCR results showed that the expression of SOX11 mRNA in the MCL patients was significantly higher than those with reactive hyperplasia lymphoid [3.097 (1.311, 6.216) and 1.058 (0.302, 2.623, respectively (p<0.05). Higher expression of SOX11 mRNA was positively correlated with some good prognostic factors such as ECOG<2, no bone marrow involvement and low-risk according to the International Prognostic Index (IPI). The comparison of the survival curves between group SOX11 mRNA

[Preliminary evaluation of PET-CT and DWI for the detection of lymphoma bone marrow infiltration].

Objective: To evaluate the clinical value of PET-CT and DWI for the detection of bone marrow infiltration of lymphoma. Methods: The bone marrow samples of 93 untreated patients with pathologically diagnosed lymphoma were retrospectively analyzed. 61 patients underwent PET-CT examination, and other 32 underwent DWI examination. With bone marrow biopsy results as "gold standard" , the rates and sites of bone marrow infiltration of various lymphoma subtypes were analyzed, and the detection rates of the two imaging techniques were compared according to different lymphoma subtypes. Results: 39 patients were diagnosed as bone marrow infiltration based on pathological examination of bone marrow biopsies from routine sampling sites and bone marrow pathological examination of biopsies guided by PET-CT and DWI. The sensitivity, specificity, accuracy, positive and negative predictive values of PET-CT for lymphoma bone marrow infiltration were 80.8%, 88.6%, 85.3%, 84.0% and 86.1%, respectively; for DWI examination, these rates were 84.6%, 89.5%, 87.5%, 84.6% and 89.5%, respectively. The detection rates of the two imaging techniques for aggressive lymphoma were 37.5% (18/48) and 38.1% (8/21), respectively, which were slightly higher than those for the indolent lymphoma [23.1% (3/13) and 27.3% (3/11)], although the differences were not statistically significant (P=0.521, P=0.660). For both aggressive lymphoma and indolent lymphoma, the detection rates of DWI were numerically slightly higher than those of PET-CT(P=0.963, P=1.000). Conclusions: PET-CT and DWI have important and similar diagnostic value for bone marrow infiltration of lymphoma. None of PET-CT and DWI can replace bone marrow biopsy (BMB). However, image-guided bone marrow biopsies can improve the detection rate of bone marrow infiltration of lymphoma.

[Clinical characteristics and prognosis of concurrent positive t(14; 18) and myc gene rearrangement in diffuse large B cell lymphoma].

OBJECTIVE: To study the incidence of positive t(14; 18) and myc gene rearrangement, and the clinical features and prognosis of concurrent positive t(14; 18) and myc gene rearrangement "double-hit lymphoma" (DHL) in diffuse large B cell lymphoma. METHODS: The positive t(14; 18) and myc gene rearrangement in 106 cases of DLBCL were analyzed using interphase fluorescent in situ hybridization (FISH) technique. The expression of myc and bcl-2 proteins was determined by immunohistochemistry. The relationship of positive t(14; 18) and myc gene rearrangement with clinical features, pathogenesis and prognosis for the patients was analyzed. SPSS 16.0 software was used for statistical analysis. RESULTS: Among the 106 cases, there were 27 (25.5%) cases with positive t(14; 18) and 13 (12.3%) cases with myc gene rearrangement, and 7 cases (6.6%) of DLBCL with concurrent t(14; 18)-positive and myc gene rearrangement. A relationship was observed between positive t(14; 18) and myc gene rearrangement (P=0.019). The follow-up data showed that the 7 DHL patients were in age of 52-84 years, the International Prognostic Index (IPI) scores were 3 in two cases, 4 in four cases and 5 in one case, and the ECOG scores were 3 in all the 7 cases. Four patients had bone marrow involvement and were combined with leukemia. The survival time ranged from 0.5 to 6 months, with a median survival of 4 months. The univariate analysis showed that B symptom, Ann Arbor stage, ECOG score, LDH level, IPI score, immunophenotype, bcl-2 protein expression, myc protein expression, and myc gene rearrangement were all associated with poor prognosis (P<0.05 for all). The multivariate analysis using a COX proportional hazard model confirmed that ECOG score, bcl-2 protein expression, myc protein expression, myc gene rearrangement, and immunophenotype were independent prognostic factors affecting survival (P<0.05 for all), among them, the myc gene rearrangement was the strongest prognostic factor (OR=4.337, P<0.001). CONCLUSIONS: "Double-hit" DLBCL is rare and can be mainly identified only by molecular detection. Perhaps positive t(14; 18) and myc gene rearrangement play concurrent role in its "double-hit" pathogenesis. DHL are highly invasive, and most of DHL patients have poor prognosis. Further studies of larger case number are required to determine the pathologic features and the therapeutic strategy of this subgroup.