Prognostic Significance Of Pim1 Expression In Primary Nodal Diffuse Large B-cell Lymphoma

ObjectiveCell–immortalization and apoptosis-hindered are the tumorigenic foundation. The research about the proliferation and apoptosis of tumor cells is helpful to reveal the pathogenesis of tumor,understand the biology of tumor,provide valuable targets for the diagnosis, treatment and prognosis of the tumor. Pim1 is a proto-oncogene,expressed in most tumor tissues, while it may inhibit the apoptosis of tumor cells, promote the proliferation of tumor cells. According to the epidemiological characteristic of NHL in china, we have chosen DLBCL as objects of study, most common pathological type of NHL. We detected the expression of pim1 in DLBCL with immunohistochemistry. The purpose of this study was to investigate the prognostic significance of pim1 protein expression in primary nodal diffuse large B-cell lymphoma (DLBCL).MethodsFrom November 1993 to April 2001, 53 patients with histologically proven diagnoses of DLBCL were enrolled at Shanghai Sixth People's Hospital and Hospital affiliated to Nantong University. According to the principle of antigen-antibody reaction, we detected the expression of pim1 in 53 cases with DLBCL with rabbit anti-human pim1 polyclonal antibody and the SP method of immunohistochemistry. Finally, we did statistical analysis combining with clinical and pathological data.Results1. Pim1 expression in DLBCL patients. In the DLBCL, there is 24 (45.2%) patients with high pim1 expression. There were no significant differences in terms of LDH, gender, age, B symptoms and stage according to the expression of pim1(P>0.05). However, there existed significant differences in terms of IPI, germinal center phenotype, complete remission of chemotherapy ,bone involvement(P<0.05). 2. Pim1 expression and response to chemotherapy in DLBCL patients. All patients were treated with 6-8 cycles of CHOP regimens at least. The complete remission rate after chemotherapy was 29.2% for patients with high pim1 expression and 68.9% for those with low pim1 expression (p = 0.006). In the univariate logistic analysis, the odds ratios for complete remission rate were 0.263 for high pim1 expression (95% CI, 0.084–0.825; P=0.022). In the multivariate logistic analysis included pim1 and IPI, these odds ratios were 0.374 for high pim1 expression (95% CI, 0.110–1.278; P=0.117) and 0.235 for high IPI (95% CI, 0.069–0.801; P=0.021).3. Prognostic significance of pim1 expression in DLBCL patients. All patients were treated with 6-8 cycles of CHOP regimens at least and followed up 32 months(range from 1 to 86 months). The 3-year overall survival rate of patients was 47.2%. Kaplan-Meier analysis revealed that the 3-year overall survival rate was higher in the pim1 low expression group than that in the pim1 high expression group. In the univariate Cox analysis, the relative risk for death was 3.7 for high pim1 expression. In the multivariate Cox analysis that included pim1 and IPI, the relative risk for death was 2.7 for high pim1 expression (95% CI, 1.2–6.3; P= 0.013) and 2.9 for high IPI (95% CI, 1.2–7.2; P = 0.012).Conclusion1. There were no significant differences in terms of LDH, gender, age, B symptoms and stage according to the expression of pim1. There existed significant differences, in terms of IPI, germinal center phenotype, complete remission of chemotherapy, bone involvement.2. In DLBCL, the complete remission rate after chemotherapy of patients with high pim1 expression is lower than low pim1 expression.3. In DLBCL, 3-year overall survival rate of patients was higher in the pim1 low expression group than that in the pim1 high expression group.