| Objective: Diffuse large B-cell lymphoma(DLBCL)is highly heterogeneous in clinical manifestations,histomorphology,immunotyping,and prognosis.The New England Journal reported that MYD88 has become a new grouping indicator of the genetic subtype of DLBCL,and it is related to the prognosis.No major cases have been reported at present.This study focused on the myeloid differentiation factor 88(MYD88)L265P mutation in DLBCL.The incidence of lymphoma and its clinicopathological characteristics were discussed in order to find the prognostic value of MYD88 L265 P mutation in DLBCL.Methods: A total cohort of 100 formalin-fixed paraffin-embedded tissue(FFPET)specimens of patients with DLBCL with complete clinical data from the First Affiliated Hospital of Xinjiang Medical University from 2010 to 2018 were selected,and the expression level of MYD88 protein was detected by immunohistochemistry(IHC).DDPCR technology was used to detect MYD88 L265 P gene mutations,follow up patients’ survival and treatment status for a long time.Chi-square test was used to analyze the relationship between MYD88 and clinical and pathological parameters of DLBCL.Spearman correlation analyse the relationship between MYD88 and other protein expressions.Kaplan-Meier Survival Analysis and Cox Proportional Risk Model were used to investigate the effect of MYD88 on prognosis.Results: The expression of MYD88 protein was 38.0% and gene mutation was 29.0%.The expression rate of primary central diffuse large B-cell lymphoma(PCNSL)(58.33%,14/24)and mutation rate(66.67%,16/24)was the highest.MYD88 expression was significantly associated with sex,extranodal site,β2-MG,BCL-2 high expression(≥70%),and survival status.MYD88L265 P mutation was significantly related to extranodal site,β2-MG,Ann-Arbor stage,and ECOG PS score.In univariate analysis,age(≥60 years),high LDH levels,NCCN-IPI score,low lymphocyte count,high NLR,rituximab treatment,high C-MYC expression(≥40%),MYD88 expression,and MYD88 L265 P mutation were significant prognostic factors ofOS.In multivariate analysis,when NCCN-IPI was controlled,MYD88 positive expression,age,high NLR,and high C-MYC expression were the independent prognostic factors affecting the OS of patients.Conclusion: MYD88 mutation is a valuable indicator to evaluate the prognosis of DLBCL.Combined with International Prognostic Index(IPI)score and Ki-67 can effectively predict the prognosis of patients,DDPCR detection of MYD88 mutation is not completely consistent with immunohistochemical results,and may be better than immunohistochemical detection. |
