The Expression Of Survivin And Bcl-6in Diffuse Large B-cell Lymphoma And Their Clinical Significance

Objective To investigate Survivin and bcl-6protein expression in diffuse large B-cell lymphoma(DLBCL), and analyze its correlation with immunosubtype and prognosis.Method Immunohistochemistry was carried out using En Vision method for Survivin、 CD10、bcl-6、MUM-1.The clinicopathologic features and follow-up data in77cases of diffuse large B-cell lymphoma were analyzed by Kaplan-Meier method,Log-rank test and Cox regression model.Result1.The percentages of tumor cells expressed Surviv、CD10、 bcl-6and MUM-1were75.3%(58/77),28.6%(22/77),74.0%(57/77)、44.2%(34/77), respectively2.36cases(46.8%)were GCB type and the rest41cases(53.2%)were non-GCB type. The expression rates of Survivin and bcl-6were72.2%(26/36) and86.1%(31/36) in GCB DLBCL, compared with82.9%(32/41) and63.4%(26/41) in non-GCB.3.There was no correlation between Survivin and bcl-6(r=0.160, P=0.163).4. The overall2,3and5-year survival rates in GCB group were77.7%,66.6%and55.6%,espectively. The overall2,3and5-year survival rates in non-GCB type group were56.1%、51.2%and41.4%,espectively The overall2,3and5-year survival rates in GCB type were higher than non-GCB type(x2=6.610, p=0.010).5. The overall2,3and5-year survival rates in Survivin positive group were65.5%、56.9%and44.8%,espectively. The overall2,3and5-year survival rates in Survivin negative group were68.4%、63.2%and57.9%,espectively (x2=2.119, p=0.146). Between the Survivin positive and negative groups, there was significant difference for survival time only in GCB subgroup(x2=3.966, P=0.046), but no difference for immunological subtype(x2=0.350, P=0.554).Howervr, its expression were connected with LDH leval and (x2=11.366, P=0.001) IPI (x2=4.614, P=0.032).6.The expression of bcl-6protein was correlated with immunological subtype(x2=5.136, P=0.023). The overall2,3and5-year survival rates in bcl-6positive group were71.9%、64.9%and56.1%,The overall2,3and5-year survival rates in bcl-6negative group were50.0%、40.0%and25.0%, espectively. There were statistical differences between positive and negative groups (x2=11.145, p=0.001)。Conclusion In univariate analysis, bcl-6, Hans classfication, clinical stage, B symptoms, number of involved sites, LDH level, International prognostic index,Eastern Cooperative Oncology Group index were found to have prognostic significance.The expression of Survivin was associated with poor survival in the GCB subgroup only. Therefor,the significance of Survivin protein expression should be assessed in the context of prospective studies.In multivariate analysis,Hans classfication, bcl-6, LDH level and International prognostic index were found were independent prognostic factors in DLBCL. But the exact mechanism of bcl-6in DLBCL remains need to be PCR or FISH further proved.