Expression of BAFF and BAFF-R in follicular lymphoma: correlation with clinicopathologic characteristics and survival outcomes

PLoS One. 2012;7(12):e50936. doi: 10.1371/journal.pone.0050936. Epub 2012 Dec 13.

Abstract

Background: B-cell activation factor (BAFF) and BAFF-receptor (BAFF-R) play crucial roles in the viability and proliferation of malignant lymphoma cells. Limited information exists regarding expression profiles and the prognostic role of BAFF and BAFF-R in follicular lymphoma (FL). We sought to determine the expression profiles of BAFF and BAFF-R in FL and to evaluate the correlation of BAFF and BAFF-R expression with clinicopathologic characteristics and outcome of FL. Correlation between expression levels of BAFF detected by immunohistochemical (IHC) and serum levels of BAFF was also evaluated.

Methods: Paraffin-embedded specimens from 115 patients were immunohistochemically examined for BAFF and BAFF-R expression. Expression levels were dichotomized into low versus high categories based on immunostaining intensity. The correlation of BAFF and BAFF-R expression with clinicopathologic characteristics and patient outcome was assessed. Serum levels of BAFF in 35 of the 115 patients with IHC data were measured by Enzyme-linked Immunosorbent assay (ELISA).

Results: BAFF and BAFF-R were expressed in 88.7% (102/115) and 87.8% (101/115) of the cases, respectively. BAFF expression was significantly correlated with only one clinicopathologic feature: Ann Arbor stage. No significant correlation was found between expression levels of BAFF detected by IHC and serum levels of BAFF detected by ELISA. High expression of BAFF-R, but not BAFF, was significantly correlated with inferior progression-free survival (PFS; P = 0.013) and overall survival (OS; P = 0.03). High expression of BAFF-R, bulky disease, and elevated lactate dehydrogenase were correlated with inferior PFS and OS in multivariate analysis. A prognostic scoring system incorporating these 3 risk factors identified 3 distinct prognostic groups with 5-year PFS of 59.4%, 41.9%, and 10.7% and OS of 91.3%, 79.7%, and 45.8%, respectively.

Conclusions: Most patients with FL variably express BAFF and BAFF-R. High expression of BAFF-R, but not BAFF, may be an independent risk factor for PFS and OS in FL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • B-Cell Activating Factor / biosynthesis*
  • B-Cell Activation Factor Receptor / biosynthesis*
  • Cell Proliferation
  • Cell Survival
  • Disease-Free Survival
  • Enzyme-Linked Immunosorbent Assay / methods
  • Female
  • Gene Expression Profiling
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Immunohistochemistry / methods
  • Lymphoma, Follicular / metabolism*
  • Male
  • Middle Aged
  • Models, Statistical
  • Prognosis
  • Treatment Outcome

Substances

  • B-Cell Activating Factor
  • B-Cell Activation Factor Receptor
  • TNFSF13B protein, human

Grants and funding

This work was supported by National Natural Science Foundation of China (81071950), Fundamental Research Funds for the Central Universities (10ykpy36), National-Eleventh Five Technology Major Project (2008ZX09312-002, 2012ZX09301), and Research Award Funds for Outstanding Young Researchers in Sun Yat-Sen Cancer Center. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.