Diffuse large B-cell lymphomas with germinal center B-cell-like differentiation immunophenotypic profile are associated with high apoptotic index, high expression of the proapoptotic proteins bax, bak and bid and low expression of the antiapoptotic protein bcl-xl

The aim of this study was to analyze the relations between differentiation immunophenotypes and the status of apoptosis and proliferation in diffuse large B-cell lymphomas. Therefore, the bc16/CD10/MUM1/CD138 differentiation immunophenotypic profiles were studied in relation to (a) the apoptotic index, (b) the apoptosis-associated bc12 family proteins bc12, bcl-xl, bax, bak, bad and bid, (c) the proliferation index (Ki67) and (d) the cell cycle proteins cyclin A, cyclin B1, cyclin D3, cyclin E, p53, Rb, p16 and p27 in 79 cases of diffuse large B-cell lymphomas. Two major differentiation immunophenotypic profiles were distinguished: the germinal center B-cell-like profile; 31 cases (bc16+/CD10+/MUM1-/CD138-: 29 cases and bc16-/CD10+/MUM1-/ CD138-: two cases) and the nongerminal center B-cell-like profile (bc16+/-/CD10-/MUM1 +/CD138-); 48 cases. The expression of bax, bak and bid and the apoptotic index were significantly higher in the germinal center B-cell-like profile than in the nongerminal center B-cell-like profile (P = 0.045, 0.018, 0.003 and 0.034, respectively). In contrast, the expression of bcl-xl was significantly lower in the germinal center B-cell-like profile than in the nongerminal center B-cell-like profile (P = 0.026). The expression of bc16 and CD10 showed significant positive correlation with the expression of bax (r = 0.659, P< 0.001 and r = 0.240, P = 0.033, respectively), bak (r = 0.391, P<0.001 and r = 0.233, P = 0.039, respectively) and bid (r = 0.652, P<0.001 and r = 0.238, P = 0.035, respectively) and significant negative correlation with the expression of bcl-xl (r= -0.536, P<0.001 and r= -0.250, P = 0.029, respectively). The expression of MUM1 showed significant negative correlation with the expression of bax (r= -0.276, P = 0.014) and bid (r= -0.266, P = 0.018) and significant positive correlation with the expression of bcl-xl (r= 0.238, P = 0.037). The above findings indicate that diffuse large B-cell lymphomas with germinal center B-cell-like immunophenotypic profile are associated with increased apoptosis status, high expression of the proapoptotic proteins bax, bak and bid and low expression of the antiapoptotic protein bcl-xl.