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오석중,구동회,서철원,김신,박봉희,강준,허주령 대한의학회 2011 Journal of Korean medical science Vol.26 No.12
Many predictive models have been proposed for better stratification of diffuse large B-cell lymphoma (DLBCL). Hans’ algorithm has been widely used as standard to sub-classify DLBCL into germinal center B-cell (GCB) and non-GCB origins. However, there have been disagreements in the literature regarding its prognostic significance. Here, we retrospectively analyzed Hans’ algorithm and the individual immunohistochemical biomarkers at different cut-off values (5%, 30%, 50% or 75%) in 94 Korean patients with DLBCL treated with combination chemotherapy with cyclophosphamide, daunorubicin,vincristine, and prednisone. No significant differences were observed between the GCB (18patients, 19.1%) and non-GCB (76, 80.9%) groups. Among individual biomarkers, CD10negativity (cut point: 30%) and bcl-6 positivity (cut point: 5%) were independent good prognostic markers in progression-free survival (PFS), whereas bcl-6 (cut point: 5%)positivity was an independent good prognostic marker in overall survival irrelevant of international prognostic index. The present study showed the lack of predictability of Hans’algorithm in DLBCL patients, and that CD10, Bcl-6 may have diverse prognostic significance at different cut-off values. Our results suggest that the proposed cut-off value may not be applied universally, and that the optimal cut-off value may need to be optimized for individual laboratory.