Objective: To determine the CARD11 expression and its prognostic value in diffuse large B cell lymphoma (DLBCL).
Methods: This retrospective study included previously untreated patients diagnosed with DLBCL from January 2007 to December 2012. Formalin-fixed, paraffin-embedded blocks of these patients were collected. Tissue microarray was built and expression of CARD11 was examined immunohistochemically. Subtype of DLBCL was determined by Hans algorithm (CD10, BCL6, MUM1). The pattern of CARD11 was further studied and their correlation with outcome was analyzed.
Results: 79 patients with DLBCL were enrolled and two reactive lymph nodes were used as control. The positive rate of high CARD11 expression in DLBCL was 65.33%, which showed no significant associations with patients' characteristics. Positive CARD11 expression was associated with an inferior event free survival (EFS)(2- year EFS: 52.03%vs 86.12%,P=0.036). Even in patients with a high international prognostic index (IPI, 3-5 points), this difference still remained significant (Median EFS not reached vs 557 days,P=0.033).
Conclusion: DLBCL patients with high CARD11 expression had a shorter EFS compared with low level of CARD11. This difference remained significant when patients were in high IPI (3-5 points), which might indicate the value of CARD11 in stratification of high-risk DLBCL patients.
目的: 了解CARD11在弥漫大B细胞淋巴瘤（DLBCL）中的表达情况及其与预后的关系。
方法: 收集经福尔马林固定、石蜡包埋的DLBCL患者治疗前淋巴结活检病理标本及临床资料，对标本进行组织芯片制备，并采用EnVision两步法对CARD11进行免疫组化染色，同时利用Hans法（CD10、BCL6、MUM1）对DLBCL标本进行分型。分析CARD11表达与患者特征及预后的关系。
结果: 共纳入79例初治DLBCL患者，采用2例反应性增生患者的淋巴结标本作为对照。对77例患者进行生存分析，75例患者可判定CARD11表达结果。在DLBCL组织的肿瘤细胞中，CARD11表达阳性率为65.33%（49/75）。CARD11与患者特征均无显著相关性。CARD11阳性组2年无事件生存（EFS）率低于阴性组（52.03％对86.12%，P=0.036）。在国际预后指数3~5分的患者中CARD11阴性组与阳性组的中位EFS率差异有统计学意义（未达到对18.7个月，P=0.033）。CARD11不是影响预后的独立危险因素。
结论: 在DLBCL中，CARD11阳性患者EFS时间显著短于CARD11阴性患者，在国际预后指数高中危和高危的患者中，这种差异依然存在，提示CARD11有助于对高危DLBCL患者进一步进行预后分层。