Research On The Prognostic Factors Of Cases With Opposite Results According To Immunophenotypic Classifications In Diffuse Large B-cell Lymphoma

Objective To investigate the prognostic factors of diffuse largeB-cell lymphoma with opposite results when analyzed by Hans’ andChoi’s classification.Methods We retrospectively reviewed paraffin blocks of154patients who were diagnosed as DLBCL at first time in the first Bethunehospital of Jilin University with complete clinical data from January2004to September2011. The expression of Ki-67, CD20, CD79a, CD3, CD43,CD5, CyclinD1, Pax-5, Bcl-2, CD10, Bcl-6and MUM1in the tumor tissuehave been displayed by immunohistochemical staining (S-P method) inall cases. With the same method, we detected GCET1and FOXP1expression in the tumor tissue. The cases with opposite results weresorted out according to Hans’ and Choi’s classifications. We applyChi-square tests to evaluate the correlation between factors of clinicalpathology and IPI score. The consistency of the two immunophenotypicclassification was analyzed by Measure of Agreement. We drew theoverall survival time curve of single factor from different level with lifetable method and compare them using Log-Rank test. Cox regressiverisk rate model was used for multiple factors in survival analysis. All theanalysis were performed with SPSS18.0statistical software and bothsides p≤0.05was considered as statistical significance.Results⑴ECOG score between2and5, Bcl-2positive, CD10negative and Bcl-6negative are shown to be independent factors of poor prognosis in154DLBCL cases.⑵The consistency of Hans’and Choi’sis good (Kappa＝0.660, p＜0.001). Consistent rate was83.8%andinconsistent rate is16.2%. According to Hans’ classification, the5yearoverall survival rate of GCB are higher than that of non-GCB (75%vs43%, p＜0.001). And overall survival time of GCB patients are longerthan that of non-GCB. According to Choi’s classification, the5yearoverall survival rate of GCB are higher than that of non-GCB(83%vs44%, p＜0.001). And overall survival time of GCB patients are longerthan that of non-GCB. The prognostic of GCB is better than non-GCBaccording to both immunophenotypic classifications.⑶In25cases withopposite results, those high risk patients with IPI between3and5haveECOG2～5more than ECOG0～1((76.9%,10/13) vs (23.1%,3/13), p＜0.001), have more Bcl-2positive expression than negative expression((92.3%,12/13) vs (7.7%,1/13), p=0.030), have more CD10negativeexpression than positive expression ((84.6%,11/13) vs (15.4%,2/13),p=0.041), have more Bcl-6negative expression than positive expression((84.6%,11/13)vs(15.4%,2/13), p=0.015). The results showed that in highrisk patients whose IPI are3～5, ECOG score2～5, positive expressionof Bcl-2, negative expression of CD10and Bcl-6have poorer prognosis.Conclusion The consistency between Hans’ classification andChoi’s classification is good. Consistent rate was83.8%. ECOG score2～5, positive expression of Bcl-2, negative expression of CD10andBcl-6are poor prognostic factors in DLBCL patients with opposite resultsaccording to two immunophenotipic classifications.