Intratumoral FOXP3+ Regulatory T Cells in Diffuse Large B-Cell Lymphoma

• Published in: Applied immunohistochemistry & molecular morphology Vol. 25; no. 8; p. 534
• Main Authors: Serag El-Dien, Marwa M, Abdou, Asmaa G, Asaad, Nancy Y, Abd El-Wahed, Moshira M, Kora, Mona Abd El-Hamid M
• Format: Journal Article
• Language: English
• Published: United States 01.09.2017
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Female; Forkhead Transcription Factors - immunology; Humans; Lymphoma, Large B-Cell, Diffuse - immunology; Lymphoma, Large B-Cell, Diffuse - pathology; Male; Middle Aged; Survival Analysis; T-Lymphocytes, Regulatory - immunology; Young Adult
• ISSN: 1533-4058
• DOI: 10.1097/PAI.0000000000000335

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma in Egypt and worldwide. Gene expression profiling classifies DLBCL into: germinal center B cell-like (GCB) and non germinal center B cell-like (non-GCB) DLBCL. Hans' algorithm has high concordance with gene expression profiling results. Regulatory T cells (Tregs) represent important modulators for the interaction between lymphoma cells and host microenvironment. FOXP3 is a popular single marker for Tregs. There is little information about the possible role of Tregs in high-grade lymphoma such as DLBCL. This study aims to assess the prognostic impact of FOXP3+ Tregs in DLBCL. The study was carried out on 70 archival cases (61 de novo DLBCL and 9 reactive follicular hyperplasia cases). DLBCL cases were classified into GCB and non-GCB groups using Hans' algorithm. All studied cases are subjected to FOXP3 immunostaining. Density of FOXP3+ Tregs was higher in reactive cases compared with DLBCL (P=0.000). In DLBCL cases, FOXP3 expression was associated with free spleen (P=0.02), early stage (P=0.05), centroblastic variant (P=0.003), and absence of necrosis (P=0.05). In germinal cases, density of FOXP3 was significantly higher in cases with good PS (P=0.02), very good and good revised international prognostic index (P=0.002), and low-risk age-adjusted international prognostic index >60 (P=0.01). Non germinal DLBCL cases with negative FOXP3 were significantly associated with splenic involvement (P=0.005). DLBCL cases with high FOXP3 have longer survival (P=0.03). T cells in the background of DLBCL may play a role in modulation of tumor progression. Their presence is associated with favorable prognostic parameters in DLBCL.