MNDA expression and its value in differential diagnosis of B-cell non-Hodgkin lymphomas: a comprehensive analysis of a large series of 1293 cases

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-04-16 DOI:10.1186/s13000-024-01481-6

Li-Fen Zhang, Yan Zhang, Rou-Hong Shui, Hong-Fen Lu, Wen-Hua Jiang, Xu Cai, Xiao-Qiu Li, Bao-Hua Yu

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Abstract

MNDA (myeloid nuclear differentiation antigen) has been considered as a potential diagnostic marker for marginal zone lymphoma (MZL), but its utility in distinguishing MZL from other B-cell non-Hodgkin lymphomas (B-NHLs) and its clinicopathologic relevance in diffuse large B-cell lymphoma (DLBCL) are ambiguous. We comprehensively investigated MNDA expression in a large series of B-NHLs and evaluated its diagnostic value. MNDA expression in a cohort of 1293 cases of B-NHLs and 338 cases of reactive lymphoid hyperplasia (RLH) was determined using immunohistochemistry and compared among different types of B-NHL. The clinicopathologic relevance of MNDA in DLBCL was investigated. MNDA was highly expressed in MZLs (437/663, 65.9%), compared with the confined staining in marginal zone B-cells in RLH; whereas neoplastic cells with plasmacytic differentiation lost MNDA expression. MNDA expression was significantly higher in mantle cell lymphoma (MCL, 79.6%, p = 0.006), whereas lower in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL, 44.8%, p = 0.001) and lymphoplasmacytic lymphoma (LPL, 25%, p = 0.016), and dramatically lower in follicular lymphoma (FL, 5.2%, p < 0.001), compared with MZL. 29.6% (63/213) of DLBCLs were positive for MNDA. The cases in non-GCB group exhibited a higher rate of MNDA positivity (39.8%) compared to those in GCB group (16.3%) (p < 0.001), and MNDA staining was more frequently observed in DLBCLs with BCL2/MYC double-expression (50%) than those without BCL2/MYC double-expression (24.8%) (p = 0.001). Furthermore, there was a significant correlation between MNDA and CD5 expression in DLBCL (p = 0.036). MNDA was highly expressed in MZL with a potential utility in differential diagnosis between MZL and RLH as well as FL, whereas its value in distinguishing MZL from MCL, CLL/SLL is limited. In addition, MNDA expression in DLBCL was more frequently seen in the non-GCB group and the BCL2/MYC double-expression group, and demonstrated a correlation with CD5, which deserves further investigation. The clinical relevance of MNDA and its correlation with the prognosis of these lymphomas also warrant to be fully elucidated.

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MNDA 表达及其在 B 细胞非霍奇金淋巴瘤鉴别诊断中的价值：对 1293 例大型系列病例的综合分析

MNDA（髓细胞核分化抗原）一直被认为是边缘区淋巴瘤（MZL）的潜在诊断标志物，但它在区分MZL和其他B细胞非霍奇金淋巴瘤（B-NHL）方面的效用及其在弥漫大B细胞淋巴瘤（DLBCL）中的临床病理相关性尚不明确。我们全面研究了MNDA在大量B-NHL中的表达，并评估了其诊断价值。我们采用免疫组化方法测定了1293例B-NHL和338例反应性淋巴细胞增生症（RLH）中MNDA的表达，并对不同类型的B-NHL进行了比较。研究还探讨了MNDA在DLBCL中的临床病理相关性。MNDA在MZLs中高表达（437/663，65.9%），而在RLH中边缘区B细胞的染色有限；浆细胞分化的肿瘤细胞则没有MNDA表达。与 MZL 相比，MNDA 在套细胞淋巴瘤（MCL，79.6%，p = 0.006）中的表达明显较高，而在慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（CLL/SLL，44.8%，p = 0.001）和淋巴浆细胞淋巴瘤（LPL，25%，p = 0.016）中的表达较低，在滤泡淋巴瘤（FL，5.2%，p < 0.001）中的表达显著较低。29.6%（63/213）的DLBCL对MNDA呈阳性。非GCB组病例的MNDA阳性率（39.8%）高于GCB组病例（16.3%）（P＜0.001），有BCL2/MYC双表达的DLBCL（50%）比无BCL2/MYC双表达的DLBCL（24.8%）更常观察到MNDA染色（P＝0.001）。此外，MNDA和CD5在DLBCL中的表达存在明显相关性（p = 0.036）。MNDA在MZL中高表达，在MZL和RLH以及FL的鉴别诊断中具有潜在作用，但在MZL和MCL、CLL/SLL的鉴别诊断中价值有限。此外，MNDA在DLBCL中的表达更多见于非GCB组和BCL2/MYC双表达组，并显示出与CD5的相关性，这值得进一步研究。MNDA的临床意义及其与这些淋巴瘤预后的相关性也有待充分阐明。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464