Expression And Clinical Significance Of CD23 And SOX11 In Mantle Cell Lymphoma

Background: Mantle cell lymphoma(MCL)is a kind of B-cell lymphoma with unique biological behavior.MCL is characterized by aggressive and indolent.The progression of MCL is rapid and the treatment effect of MCL is poor.which is currently the focus of clinical attention.The histologic features of classical MCL is characterized by small to medium sized lymphocytes,and the characteristic immune markers of MCL are CD5 positive and CyclinD1 postive.Small lymphocytic lymphoma(SLL)is an indolent B-cell lymphoma,which is similar to MCL in morphology,but the immunohistochemistry about SLL is characterized by CD5 positive and CyclinD1 positive.In the past,MCL and SLL could be distinguished by pathological morphology and characteristic immune markers,but in recent years,a few studies have shown that CD23 can also be expressed in MCL,which brings confusion to the differential diagnosis.Secondly,in recent years,studies have found that SOX11 is expressed in MCL,which has certain diagnostic value for MCL,especially for CyclinD1 negative MCL,however,there are different reports on the relationship between SOX11 expression and prognosis in MCL,Based on this,we study the expression and clinical significance of CD23 and SOX11 in MCL,which is important for the differential diagnosis of MCL.Objective: The purpose of this subject is to investigate the expression of CD23 and SOX11 in MCL,to provide more evidence for the differential diagnosis of MCL and SLL,and to explore the relationship between the expression of CD23,SOX11 in MCL with its clinical features and prognostic influence.Methods:1.From September 2009 to January 2020,41 cases of MCL were collected from the Department of pathology of Shaanxi Provincial People's hospital.At the same time,30 cases of diffuse large B-cell lymphoma(DLBCL),5 cases of B lymphoblastic lymphoma,2 cases of Burkitt lymphoma and 7 cases of SLL were taken as controls.IHC staining wasused for the detection of CD23 and SOX11 in all the cases to investigate the expression of CD23 and SOX11 in MCL.2.The clinical data of 37 cases of MCL were collected,30 cases of MCL were followed up,and analyzed the relationship between the expression of CD23,SOX11 in MCL with its clinical features and prognostic influence.3.Two MCL samples with CyclinD1 negative and SOX11 positive were collected.CCND1 / IGH fusion gene was detected by FISH technology in two MCL cases,and CCND1 / IGH fusion gene was observed.Results:1.The positive rate of CD23 in MCL is 34%,and the positive rates of SOX11 in DLBCL,SLL are 6.7%,100% respectively,but CD23 is not expressed in Burkitt lymphoma,B lymphoblastic lymphoma and reactive hyperplasia of lymph nodes.There was significant difference in the expression of CD23 in MCL,DLBCL,SLL and reactive hyperplasia of lymph nodes(p<0.05);There was no significant correlation between the expression of CD23 in MCL and gender,age,lymph node size,platelet count,hemoglobin content,leukocyte count,lactate dehydrogenase,spleen enlargement,B symptoms,Ann Arbor stage(p>0.05).2.The positive rate of SOX11 in MCL is 88%,and the positive rates of SOX11 in B lymphoblastoma is 20%,but SOX11 is not expressed in DLBCL,Burkitt lymphoma,SLL and reactive hyperplasia of lymph nodes.The expression of SOX11 in MCL,DLBCL,B lymphoblastic lymphoma,SLL and reactive hyperplasia of lymph nodes was statistically significant(p<0.05);There was no significant correlation between the expression of SOX11 in MCL and gender,age,lymph node size,platelet count,hemoglobin content,leukocyte count,lactate dehydrogenase,spleen enlargement,B symptoms,Ann Arbor stage(p>0.05).3.Among 41 patients with MCL,30 patients had complete follow-up information,11 patients had lost follow-up information.Among the 30 patients followed up,19 patients survived and 11 patients died,with a survival rate of 63.3%.The overall survival time of positive CD23 group was shorter than the negative CD23 group(33 monthes vs 73monthes).There was no significant difference between them(p=0.650,p>0.05).The one-year survival rate of SOX11 positive patients was 80.8%.Because of the small sample size,the one-year survival rate of SOX11 negative patients could not be calculated,and the median survival time of the two kinds of patients could not be calculated.There wasno significant difference between them(p=0.336,p>0.05).4.Among the 2 cases of MCL with CyclinD1 negative and SOX11 positive,1 case of MCL was positive for FISH,and the positive tumor cells of CCND1/IGH fusion gene were more than 10%.The other case of MCL was negative for FISH,and the positive tumor cells of CCND1/IGH fusion gene were less than 10%.Conclusion:1.CD23 has a certain expression in MCL,mostly weak positive expression.The expression was no significally correlated with the clinical features and prognosis of MCL patients.2.SOX11 is highly expressed in the MCL,which is a specific indicator.SOX11 can be used as a immune marker for MCL.The expression was no significally correlated with the clinical features and prognosis of MCL patients.3.The MCL of CyclinD1-and SOX11+ has CCND1/IGH fusion gene.