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Evaluation of NF-κB subunit expression and signaling pathway activation demonstrates that p52 expression confers better outcome in germinal center B-cell-like diffuse large B-cell lymphoma in association with CD30 and BCL2 functions.

NF-κB亚单位表达和信号通路激活状态检测表明有p52表达的生发中心B细胞样DLBCL患者预后较好与CD30和BCL2功能相关

Ok CY,Xu-Monette ZY,Li L,Manyam GC,Montes-Moreno S,Tzankov A,Visco C,Dybkær K,Routbort MJ,Zhang L,Chiu A,Orazi A,Zu Y,Bhagat G,Richards KL,Hsi ED,Choi WW,van Krieken JH,Huh J,Ponzoni M,Ferreri AJ,Parsons BM,Rao H,Møller MB,Winter JN,Piris MA,Wang SA,Medei

Abstract

Nuclear factor-κB (NF-κB) is a transcription factor with a well-described oncogenic role. Study for each of five NF-κB pathway subunits was only reported on small cohorts in diffuse large B-cell lymphoma (DLBCL). In this large cohort (n=533) of patients with de novo DLBCL, we evaluated the protein expression frequency, gene expression signature, and clinical implication for each of these five NF-κB subunits. Expression of p50, p52, p65, RELB, and c-Rel was 34%, 12%, 20%, 14%, and 23%, whereas p50/p65, p50/c-Rel, and p52/RELB expression was 11%, 11%, and 3%, respectively. NF-κB subunits were expressed in both germinal center B-cell-like (GCB) and activated B-cell-like (ABC) DLBCL, but p50 and p50/c-Rel were associated with ABC-DLBCL. p52, RELB, and p52/RELB expressions were associated with CD30 expression. p52 expression was negatively associated with BCL2 (B-cell lymphoma 2) expression and BCL2 rearrangement. Although p52 expression was associated with better progression-free survival (PFS) (P=0.0170), singular expression of the remaining NF-κB subunits alone did not show significant prognostic impact in the overall DLBCL cohort. Expression of p52/RELB was associated with better overall survival (OS) and PFS (P=0.0307 and P=0.0247). When cases were stratified into GCB- and ABC-DLBCL, p52 or p52/RELB dimer expression status was associated with better OS and PFS (P=0.0134 and P=0.0124) only within the GCB subtype. However, multivariate analysis did not show p52 expression to be an independent prognostic factor. Beneficial effect of p52 in GCB-DLBC appears to be its positive correlation with CD30 and negative correlation with BCL2 expression. Gene expression profiling (GEP) showed that p52(+) GCB-DLBCL was distinct from p52(-) GCB-DLBCL. Collectively, our data suggest that DLBCL patients with p52 expression might not benefit from therapy targeting the NF-κB pathway.

摘要

核因子-κB (NF-κB)是一种明确有致癌作用的转录因子。弥漫大B细胞淋巴瘤(DLBCL)中5个NF-κB通路亚单位的作用研究仅有小样本报道。本文为大样本研究,共评估533例原发性DLBCL患者5个NF-κB亚单位中每个亚单位的蛋白表达率、基因表达特征及其临床意义。P50、p52、p65、RELB和c-Rel的表达率分别为34%、12%、20%、14%和23%,而p50/p65、p50/c-Rel和p52/RELB的表达率分别为11%、11%和3%。生发中心B细胞样(GCB)DLBCL和活化B细胞样(ABC)DLBCL均表达NF-κB亚单位,但p50和p50/c-Rel的表达与ABC-DLBCL相关,p52、RELB和p52/RELB的表达与CD30表达呈正相关,p52表达与BCL2表达和BCL2重排呈负相关。尽管p52表达与无进展生存期(PFS)较长相关(P=0.0170),但仅凭某个NF-κB亚单位表达不能说明它对大样本DLBCL预后有显著影响。p52/RELB表达与总体生存期(OS)和PFS较长相关(P值分别为0.0307和0.0247)。将DLBCL分为GCB-DLBCL和ABC-DLBCL两组,仅GCB-DLBCL显示p52或p52/RELB二聚体的表达与OS和PFS较长相关(P值分别为0.0134和0.0124)。然而,多变量分析未显示p52表达为独立预后因素。GCB-DLBCL中p52对预后的有利影响,似乎是因为它的表达与CD30表达呈正相关而与BCL2表达呈负相关。基因表达谱(GEP)显示p52阳性的GCB-DLBCL不同于p52阴性的GCB-DLBCL。总之,我们的研究提示表达p52的DLBCL患者可能不会从NF-κB通路靶向治疗中获益。

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