Immunohistochemical evaluation of CD10, BCL6, BCL2, MUM1 and MYC in diffuse large B-cell brain lymphoma; diagnostic and prognostic significance

Introduction: Although the prognosis of primary central nervous system lymphoma (PCNSL), a progressive neoplasm of the central nervous system, has improved with the use of current therapies, the overall survival rate of patients is still low. Objectives: Since the identification of factors that affect the survival of these patients can help physicians choose the best treatment and prognosis, this study aimed to investigate the diagnostic and prognostic significance of immunohistochemical biomarkers in patients with diffuse large B-cell lymphoma (DLBCL), as the most common type of PCNSL. Patients and Methods: In this descriptive-cross-sectional, 30 histological block samples from patients diagnosed with DLBCL were subjected to tissue preparation and immunohistochemical staining with multiple myeloma oncogene-1 (MUM1), B cell lymphoma-6 (BCL-6), B cell lymphoma-2 (BCL-2), cluster differentiation 10 (CD10), and MYC antibodies, and their expression rates were determined subsequently. Patients’ characteristics, including survival status and survival time after diagnosis, were extracted from patients’ records. Results: Immunohistochemistry positivity for MUM1, BCL-6, BCL-2, CD10, and MYC biomarkers were seen in 25 (83%), 21 (70%), 25 (83%), 2 (7%), 25 (83%) and 0 (0%), respectively. According to the Hans algorithm, 24 patients (80%) were activated B cell (ABC) and 6 patients (20 %) were germinal center B cell (GCB). Totally, 23 (77%) patients have died during the study period. The mean survival time of patients was 12 months (95% CI: 14.47-33.24). There was no significant difference in death rate for different categories of variables such as demographic characteristics, DLBCL subgroup, and biomarker positive rates (P>0.05). According to the univariate cox model, the immunohistochemistry (IHC) reactivity rate for the studied biomarkers did not significantly affect the survival. In contrast, chemotherapy and radiotherapy reduce the hazard of death by 72% and 65%, respectively. Conclusion: The results of the present study revealed that the expression rate of MUM1, BCL-6, BCL-2, CD10, and MYC could not be used as a proper prognostic biomarker for DLBCL patients.