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NF-kappa B p50 activation associated with immune dysregulation confers poorer survival for diffuse large B-cell lymphoma patients with wild-type p53

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机构: [1]Sun Yat Sen Univ, Ctr Canc, State Key Lab Oncol South China, Dept Med Oncol,Collaborat Innovat Ctr Canc Med, Guangzhou, Guangdong, Peoples R China; [2]Univ Texas MD Anderson Canc Ctr, Dept Hematopathol, 1515 Holcombe Blvd, Houston, TX 77030 USA; [3]Peking Univ, Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Minist Educ,Dept Lymphoma, Beijing, Peoples R China; [4]Univ Texas MD Anderson Canc Ctr, Dept Bioinformat & Computat Biol, Houston, TX 77030 USA; [5]Univ Hosp, Dept Pathol, Basel, Switzerland; [6]Cleveland Clin, Dept Pathol, Cleveland, OH 44106 USA; [7]Odense Univ Hosp, Dept Pathol, Odense, Denmark; [8]Univ Texas Sch Med, Grad Sch Biomed Sci, Houston, TX USA
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Dysregulated NF-kappa B signaling is critical for lymphomagenesis, however, the expression and clinical relevance of NF-kappa B subunit p50 in diffuse large B-cell lymphoma have not been evaluated. In this study, we analyzed the prognostic significance and gene expression signatures of p50 nuclear expression as a surrogate for p50 activation in 465 patients with de novo diffuse large B-cell lymphoma. We found that p50(+) nuclear expression, observed in 34.6% of diffuse large B-cell lymphoma, predominantly composed of activated B-cell-like subtype, was an independent adverse prognostic factor in patients with activated B-cell-like diffuse large B-cell lymphoma. It was also an adverse prognostic factor in patients with wild-type TP53 independent of the activated B-cell-like and germinal center B-cell-like subtypes, even though p50 activation correlated with significantly lower levels of Myc, PI3K, phospho-AKT, and CXCR4 expression and less frequent BCL2 translocations. In contrast, in germinal center B-cell-like diffuse large B-cell lymphoma patients with TP53 mutations, p50(+) nuclear expression correlated with significantly better clinical outcomes, and decreased p53, Bcl-2, and Myc expression. Gene expression profiling revealed multiple signaling pathways potentially upstream the p50 activation through either canonical or noncanonical NF-kappa B pathways, and suggested that immune suppression, including that by the immune checkpoint TIM-3 and that through leukocyte immunoglobulin-like receptors, but not antiapoptosis and proliferation, may underlie the observed poorer survival rates associated with p50(+) nuclear expression in diffuse large B-cell lymphoma. In conclusion, these data show that p50 is important as a unique mechanism of R-CHOP-resistance in activated B-cell-like diffuse large B-cell lymphoma and in patients without TP53 mutations. The results also provide insights into the regulation and function of p50 in diffuse large B-cell lymphoma and its cross talk with the p53 pathway with important therapeutic implications.

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出版当年[2017]版:
大类 | 2 区 医学
小类 | 1 区 病理学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 病理学
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第一作者机构: [1]Sun Yat Sen Univ, Ctr Canc, State Key Lab Oncol South China, Dept Med Oncol,Collaborat Innovat Ctr Canc Med, Guangzhou, Guangdong, Peoples R China; [2]Univ Texas MD Anderson Canc Ctr, Dept Hematopathol, 1515 Holcombe Blvd, Houston, TX 77030 USA;
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通讯机构: [2]Univ Texas MD Anderson Canc Ctr, Dept Hematopathol, 1515 Holcombe Blvd, Houston, TX 77030 USA; [8]Univ Texas Sch Med, Grad Sch Biomed Sci, Houston, TX USA
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