미만성 거대 B세포 림프종 및 성숙 T세포 림프종에서 CD30 단백질의 발현이 가지는 임상병리학적 의미에 관한 연구

Abstract

Aim: The role of tumor necrosis factor receptor CD30 in the pathogenesis and prognosis of lymphomas remains unclear. We examined CD30 expression in diffuse large B-cell lymphoma (DLBCL) and mature T-cell lymphoma (MTCL), along with tumor necrosis factor receptor associated factor 1 (TRAF1) expression, to explore CD30-related nuclear factor-κB (NF-κB) pathways in DLBCL. Methods: Immunohistochemical analyses were conducted in 103 patients (49 DLBCL and 54 MTCL (25 peripheral T-cell lymphoma, 21 NK/T-cell lymphoma, 8 angioimmunoblastic T-cell lymphoma)). Clinical data including age, gender, response to chemotherapy, serum LDH, ECOG (Eastern Cooperative Oncology Group) performance, Ann Arbor stage, IPI (International Prognostic Index) risk, B symptoms, lymphadenopathy, bone marrow and extranodal involvement, and survival, were investigated. Results: Positive CD30 expression was associated with poor response to chemotherapy (p = 0.029), aggravated ECOG performance (p = 0.011), and advanced Ann Arbor stage (p = 0.036) in DLBCL. It was associated with positive Epstein-Barr encoding region in situ hybridization (EBER-ISH) (p = 0.011) and TRAF1 expression (p = 0.015) in DLBCL. Among the total of 49 DLBCL, CD30 was not associated with overall survival (p = 0.151, log-rank test), but predicted survival in 21 DLBCL patients with partial or complete remission (p < 0.001, log-rank test), 23 with normal LDH (p = 0.009, log-rank test), 16 with lymphadenopathy (p = 0.034, log-rank test), 31 with early Ann Arbor staging (p < 0.001, log-rank test), and 24 low IPI (p = 0.024, log-rank test). In MTCL, no link between CD30 and EBER-ISH emerged. Among all 54 MTCL patients, CD30 was not associated with overall survival (p = 0.196, log-rank test), but predicted survival in 13 MTCL with normal LDH (p = 0.023, log-rank test). Conclusions: Positive expression of CD30 is associated with aggressive disease and TRAF1 expression in DLBCL, indirectly suggesting a role of the NF-κB signaling pathway in CD30-related disease progression. CD30 could be used as a novel marker predicting disease outcome in early-stage DLBCL.