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Abstract：
BACKGROUND: Diffuse large B-cell lymphomas (DLBCLs) are a group of malignant neoplasms with extensive clinical and molecular heterogeneity. Several key genetic aberrations have been identified, such as those involving the MYC, BCL6, and BCL2 genes. Prior studies on the prognostic significance of Bcl-2 protein expression in DLBCL have been contradictory, with some suggesting it has an adverse effect, while others have shown no such association. Bcl-2 is known to be more highly expressed in the non-germinal center B-cell-like (non-GCB) subtype compared to germinal center B-cell-like (GCB) DLBCL. Non-GCB status is associated with a less favorable prognosis. This study aimed to investigate whether the expression of Bcl-2 protein in non-GCB DLBCL influences response to treatment, progression-free survival, or overall survival.
METHODS: In this retrospective study, we investigated whether there was a difference in the clinical outcomes of non-GCB DLBCL cases (n = 97) that were confirmed by immunochemistry to demonstrate high levels of Bcl-2 protein expression (>50% neoplastic cells stained) when compared to those who were deemed negative based on this criterion. Response to rituximab-based induction immunochemotherapy, five-year progression-free survival, and five-year overall survival were assessed.
RESULTS: There was no statistically significant difference in response to treatment, five-year progression-free survival, or five-year overall survival between the patients who were positive for Bcl-2 (n = 70) compared to those who were considered Bcl-2 negative (n = 27).
CONCLUSIONS: High levels of Bcl-2 protein expression do not appear to be of prognostic significance in non-GCB DLBCL and therefore Bcl-2 may not be a key therapeutic target in the treatment and improvement of clinical outcome in such cases.
METHODS: In this retrospective study, we investigated whether there was a difference in the clinical outcomes of non-GCB DLBCL cases (n = 97) that were confirmed by immunochemistry to demonstrate high levels of Bcl-2 protein expression (>50% neoplastic cells stained) when compared to those who were deemed negative based on this criterion. Response to rituximab-based induction immunochemotherapy, five-year progression-free survival, and five-year overall survival were assessed.
RESULTS: There was no statistically significant difference in response to treatment, five-year progression-free survival, or five-year overall survival between the patients who were positive for Bcl-2 (n = 70) compared to those who were considered Bcl-2 negative (n = 27).
CONCLUSIONS: High levels of Bcl-2 protein expression do not appear to be of prognostic significance in non-GCB DLBCL and therefore Bcl-2 may not be a key therapeutic target in the treatment and improvement of clinical outcome in such cases.
摘要：
背景：弥漫性大B细胞淋巴瘤（DLBCLs）是一组具有广泛临床和分子异质性的恶性肿瘤。已经确定了几个关键的遗传畸变，比如那些涉及MYC的，BCL6和BCL2基因。关于Bcl-2蛋白表达在DLBCL中的预后意义的先前研究一直存在矛盾，有些人认为它有不利影响，而其他人则没有表现出这种联系。已知与生发中心B细胞样(GCB)DLBCL相比,Bcl-2在非生发中心B细胞样(非GCB)亚型中更高表达。非GCB状态与预后较差相关。本研究旨在探讨Bcl-2蛋白在非GCBDLBCL中的表达是否影响治疗反应，无进展生存期,或总体生存率。
方法：在这项回顾性研究中，我们调查了非GCB型DLBCL病例(n=97)的临床结局是否与根据该标准被认为阴性的病例相比,通过免疫化学证实显示高水平的Bcl-2蛋白表达(>50%肿瘤细胞染色)存在差异.对基于利妥昔单抗的诱导免疫化疗的反应，5年无进展生存期,并评估5年总生存率.
结果：对治疗的反应没有统计学上的显着差异，5年无进展生存期,或与Bcl-2阴性患者（n=27）相比，Bcl-2阳性患者（n=70）的5年总生存率。
结论：Bcl-2蛋白的高水平表达在非GCBDLBCL中似乎没有预后意义，因此Bcl-2可能不是治疗和改善此类病例临床结果的关键治疗靶标。
方法：在这项回顾性研究中，我们调查了非GCB型DLBCL病例(n=97)的临床结局是否与根据该标准被认为阴性的病例相比,通过免疫化学证实显示高水平的Bcl-2蛋白表达(>50%肿瘤细胞染色)存在差异.对基于利妥昔单抗的诱导免疫化疗的反应，5年无进展生存期,并评估5年总生存率.
结果：对治疗的反应没有统计学上的显着差异，5年无进展生存期,或与Bcl-2阴性患者（n=27）相比，Bcl-2阳性患者（n=70）的5年总生存率。
结论：Bcl-2蛋白的高水平表达在非GCBDLBCL中似乎没有预后意义，因此Bcl-2可能不是治疗和改善此类病例临床结果的关键治疗靶标。
