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He M, Chen K, Li S, Zhang S, Zheng J, Hu X, Gao L, Chen J, Song X, Zhang W, Wang J, Yang J. Clinical Significance of "Double-hit" and "Double-protein" expression in Primary Gastric B-cell Lymphomas. J Cancer 2016; 7:1215-25. [PMID: 27390596 PMCID: PMC4934029 DOI: 10.7150/jca.15395] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 04/26/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIMS: Primary gastric B-cell lymphoma is the second most common malignancy of the stomach. There are many controversial issues about its diagnosis, treatment and clinical management. “Double-hit” and “double-protein” involving gene rearrangement and protein expression of c-Myc and bcl2/bcl6 are the most used terms to describe DLBCL poor prognostic factors in recent years. However, very little is known about the role of these prognostic factors in primary gastric B-cell lymphomas. This study aims to obtain a molecular pathology prognostic model of gastric B-cell lymphoma for clinical stratified management by evaluating how the “double-hit” and “double-protein” in tumor cells as well as microenvironmental reaction of tumor stromal tissue affect clinical outcome in primary gastric B-cell lymphomas. METHODS: Data and tissues of 188 cases diagnosed with gastric B-cell lymphomas were used in this study. Tumor tissue microarray (TMA) of formalin fixed and paraffin embedded (FFPE) tissues was constructed for fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) analysis with a serial of biomarkers containing MYC, BCL2, BCL6, CD31, SPARC, CD10, MUM1 and Ki-67. Modeled period analysis was used to estimate 3-year and 5-year overall survival (OS) and disease-free survival (DFS) distributions. RESULTS: There was no definite “double-hit” case though the gene rearrangement of c-Myc (5.9%), bcl2 (0.1%) and bcl6 (7.4%) was found in gastric B-cell lymphomas. The gene amplification or copy gains of c-Myc (10.1%), bcl-2 (17.0%) and bcl-6 (0.9%) were present in these lymphomas. There were 12 cases of the lymphomas with the “double-protein” expression of MYC and BCL2/BCL6. All patients with “double-protein” gastric B-cell lymphomas had poor outcome compared with those without. More importantly, “MYC-BCL2-BCL6” negative group of gastric B-cell lymphoma patients had favorable clinical outcome regardless clinical stage, pathological types and therapeutic modalities. And the similar better prognosis was found in the cases with low microvessel density (MVD) in tumor tissue and high expression of SPARC (SPARC≥5%) in stromal cells. CONCLUSIONS: “Double-hit” lymphoma was rare among primary gastric lymphoma, while patients with multiple gene amplification and/or copy gains of c-Myc, bcl2 and bcl6, and “double-protein” gastric B-cell lymphomas had a poor clinical outcome. In addition, patients with MYC, BCL2 and BCL6 expression negative or low MVD in tumor tissue with high expression of SPARC in stromal cells could have better prognosis than other gastric B-cell lymphomas regardless of their clinical stage and pathological types. These results would be of very importance for clinical stratified management and precision medicine of gastric B-cell lymphomas.
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Affiliation(s)
- Miaoxia He
- 1. Department of Pathology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, CHINA; 2. Molecular Pathology, Cellular & Molecular Pathology Branch, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Keting Chen
- 3. Department of Hematology, Changhai Hospital, The Second Military Medical University, University, Shanghai 200433, CHINA
| | - Suhong Li
- 4. Department of Pathology, Children Hospital and Women Health Center of Shanxi, Taiyuan 030013, CHINA
| | - Shimin Zhang
- 5. Division of Molecular Pathology, Joint Pathology Center, Washington, DC 20817, USA
| | - Jianming Zheng
- 1. Department of Pathology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, CHINA
| | - Xiaoxia Hu
- 3. Department of Hematology, Changhai Hospital, The Second Military Medical University, University, Shanghai 200433, CHINA
| | - Lei Gao
- 3. Department of Hematology, Changhai Hospital, The Second Military Medical University, University, Shanghai 200433, CHINA
| | - Jie Chen
- 3. Department of Hematology, Changhai Hospital, The Second Military Medical University, University, Shanghai 200433, CHINA
| | - Xianmin Song
- 3. Department of Hematology, Changhai Hospital, The Second Military Medical University, University, Shanghai 200433, CHINA
| | - Weiping Zhang
- 3. Department of Hematology, Changhai Hospital, The Second Military Medical University, University, Shanghai 200433, CHINA
| | - Jianmin Wang
- 3. Department of Hematology, Changhai Hospital, The Second Military Medical University, University, Shanghai 200433, CHINA
| | - Jianmin Yang
- 3. Department of Hematology, Changhai Hospital, The Second Military Medical University, University, Shanghai 200433, CHINA
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Zeggai S, Harir N, Tou A, Sellam F, Mrabent MN, Salah R. Immunohistochemistry and scoring of Ki-67 proliferative index and p53 expression in gastric B cell lymphoma from Northern African population: a pilot study. J Gastrointest Oncol 2016; 7:462-8. [PMID: 27284480 DOI: 10.21037/jgo.2016.01.01] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This study aimed to clarify the Ki-67 distribution, p53 expression and their relationship with clinico-pathologic features of gastric B cell lymphoma from Northern African population. METHODS Twenty paraffin blocks of gastric lymphoma were retrieved from the archival materials of Department of Pathology, Central University Hospital of Sidi Bel Abbes (Western Algeria) from 2007 to 2013. Four µm section specimens were stained by immunohistochemical (IHC) technique with Ki-67 and p53 tumor markers. P values <0.05 were considered statistically significant. RESULTS Expression of p53 proteins and the mean proliferative index (PI) were compared between high grade gastric B cell lymphomas (DLBCL) and low grade gastric B cell lymphomas (gastric MALTs). p53 overexpression (P=0.007) and a high proliferation index Ki-67 (P=0.001) were significantly associated with gastric DLBCL. We found also a statistically significant correlation between p53 and Ki-67 (P=0.007) but no obvious relationships were found between Ki-67 PI and p53 expression as well as clinico-pathological features (age, sex, location, macroscopic type). CONCLUSIONS The IHC studies of Ki-67 and p53 expression in gastric B cell lymphoma can help in monitoring of patients at risk, and to give suitable treatment and management of patients.
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Affiliation(s)
- Soumia Zeggai
- 1 Molecular Microbiology Laboratory, Health and Proteomics, Department of Biology, UDL-SBA, Ex-ITMA, Sidi Bel Abbes, Algeria ; 2 Environment and Cancer Laboratory, Department of Pathology, Central University Hospital, Sidi Bel Abbes, Algeria
| | - Noria Harir
- 1 Molecular Microbiology Laboratory, Health and Proteomics, Department of Biology, UDL-SBA, Ex-ITMA, Sidi Bel Abbes, Algeria ; 2 Environment and Cancer Laboratory, Department of Pathology, Central University Hospital, Sidi Bel Abbes, Algeria
| | - Abdelnacer Tou
- 1 Molecular Microbiology Laboratory, Health and Proteomics, Department of Biology, UDL-SBA, Ex-ITMA, Sidi Bel Abbes, Algeria ; 2 Environment and Cancer Laboratory, Department of Pathology, Central University Hospital, Sidi Bel Abbes, Algeria
| | - Feriel Sellam
- 1 Molecular Microbiology Laboratory, Health and Proteomics, Department of Biology, UDL-SBA, Ex-ITMA, Sidi Bel Abbes, Algeria ; 2 Environment and Cancer Laboratory, Department of Pathology, Central University Hospital, Sidi Bel Abbes, Algeria
| | - Meriem N Mrabent
- 1 Molecular Microbiology Laboratory, Health and Proteomics, Department of Biology, UDL-SBA, Ex-ITMA, Sidi Bel Abbes, Algeria ; 2 Environment and Cancer Laboratory, Department of Pathology, Central University Hospital, Sidi Bel Abbes, Algeria
| | - Rachida Salah
- 1 Molecular Microbiology Laboratory, Health and Proteomics, Department of Biology, UDL-SBA, Ex-ITMA, Sidi Bel Abbes, Algeria ; 2 Environment and Cancer Laboratory, Department of Pathology, Central University Hospital, Sidi Bel Abbes, Algeria
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Bockorny B, Dasanu CA. HMG-CoA reductase inhibitors as adjuvant treatment for hematologic malignancies: what is the current evidence? Ann Hematol 2014; 94:1-12. [PMID: 25416152 DOI: 10.1007/s00277-014-2236-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
Abstract
Statins have been shown to possess properties that go beyond their lipid-lowering effects. These agents act on the mevalonate pathway and inhibit synthesis of cholesterol, geranylgeranyl pyrophosphate, and farnesyl pyrophosphate, which are necessary for posttranslational modification of the Rho, Rac, and Ras superfamily of proteins. Early phase studies have demonstrated that this modulation of cellular signaling can ultimately exert pro-apoptotic, anti-angiogenic, and immunomodulatory effects, and might even restore chemosensitivity in several hematologic cancers. Nonetheless, these promising preclinical results have not yet migrated from the bench to the bedside as their effectiveness as adjuvant agents in hematologic malignancies is currently uncertain. In the present review, we summarize the existing evidence stemming from preclinical and clinical studies pertaining to the use of statins as adjuvant therapies in hematologic malignancies, and discuss the new insights gained from the ongoing translational research.
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Affiliation(s)
- Bruno Bockorny
- Division of Hematology and Oncology, Beth Israel Deaconess Medical Center-Harvard School of Medicine, 330 Brookline Avenue, Boston, MA, 02215, USA,
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