Abstract
A clinical course of patients with mantle cell lymphoma (MCL) is aggressive, and the disease is rarely curable. Proliferation rate is the most important prognostic factor. We developed a novel, reliable, rapid, and routinely applicable approach allowing a precise quantitative assessment of three proliferation markers, Ki-67, topoisomerase IIα, and TPX2. A total of 95 lymphoma specimens were measured in the study by real-time reverse transcription PCR (RQ-RT-PCR). We tested the reproducibility and accuracy of the assay and correlated the results with the immunohistochemical staining of the corresponding proteins. The results obtained indicated individual variability of the mRNA expression levels, reflecting heterogeneity of the proliferation rate in individual patients. In general, we observed the highest mRNA expression in the group of Burkitt lymphomas and the lowest in patients with reactive lymphadenopathies. We found increased proliferation rate in MCLs with high cyclin D1 mRNA, indicating a quantitative control of the cell cycle. We observed a correlation between mRNA expression level and the immunohistochemical staining of corresponding proteins, which significantly argues for the prognostic significance of the mRNA expression measuring. We confirmed the accuracy of the current assay for a precise quantitative examination of the proliferation activity. Real-time RT-PCR provides a novel approach applicable for clinical trials, and it represents a potent approach allowing to stratify MCL patients for entry into clinical trials according to the expression of the proliferation signature genes in their tumors. This approach may contribute to improved and individualized therapeutic options respecting the individual progression risk of patients with MCL.


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References
Swerdlow SH, Berger F, Isaacson PI et al (2001) Mantle cell lymphoma. In: Jaffe ES, Harris NC, Stein H, Vardiman JW (eds) Pathology and genetics of tumours of haematopoietic and lymphoid tissues, 1st edn. IARC, Lyon, pp 168–170
Weisenburger DD, Armitage JO (1996) Mantle cell lymphoma—an entity comes of age. Blood 87:4483–4494
Bosch F, Lopez-Guillermo A, Campo E et al (1998) Mantle cell lymphoma: presenting features, response to therapy, and prognostic factors. Cancer 82:567–575
Campo E, Raffeld M, Jaffe ES (1999) Mantle-cell lymphoma. Semin Hematol 36:115–127
Lenz G, Dreyling M, Hiddemann W (2004) Mantle cell lymphoma: established therapeutic options and future directions. Ann Hematol 83:71–77
Raty R, Franssila K, Joensuu H et al (2002) Ki-67 expression level, histological subtype, and the International Prognostic Index as outcome predictors in mantle cell lymphoma. Eur J Haematol 69:11–20
Tiemann M, Schrader C, Klapper W et al (2005) Histopathology, cell proliferation indices and clinical outcome in 304 patients with mantle cell lymphoma (MCL): a clinicopathological study from the European MCL Network. Br J Haematol 131:29–38
Ott G, Kalla J, Ott MM et al (1997) Blastoid variants of mantle cell lymphoma: frequent bcl-1 rearrangements at the major translocation cluster region and tetraploid chromosome clones. Blood 89:1421–1429
Matutes E, Parry-Jones N, Brito-Babapulle V et al (2004) The leukemic presentation of mantle-cell lymphoma: disease features and prognostic factors in 58 patients. Leuk Lymphoma 45:2007–2015
Orchard J, Garand R, Davis Z et al (2003) A subset of t(11;14) lymphoma with mantle cell features displays mutated IgVH genes and includes patients with good prognosis, nonnodal disease. Blood 101:4975–4981
Yatabe Y, Suzuki R, Tobinai K et al (2000) Significance of cyclin D1 overexpression for the diagnosis of mantle cell lymphoma: a clinicopathologic comparison of cyclin D1-positive MCL and cyclin D1-negative MCL-like B-cell lymphoma. Blood 95:2253–2261
Levy V, Ugo V, Delmer A et al (1999) Cyclin D1 overexpression allows identification of an aggressive subset of leukemic lymphoproliferative disorder. Leukemia 13:1343–1351
Fu K, Weisenburger DD, Greiner TC et al (2005) Cyclin D1-negative mantle cell lymphoma: a clinicopathologic study based on gene expression profiling. Blood 106:4315–4321
Schrader C, Janssen D, Meusers P et al (2005) Repp 86: a new prognostic marker in mantle cell lymphoma. Eur J Haematol 75:498–504
Schrader C, Meusers P, Brittinger G et al (2004) Topoisomerase IIalpha expression in mantle cell lymphoma: a marker of cell proliferation and a prognostic factor for clinical outcome. Leukemia 18:1200–1206
Determann O, Hoster E, Ott G et al (2008) Ki-67 predicts outcome in advanced-stage mantle cell lymphoma patients treated with anti-CD20 immunochemotherapy: results from randomized trials of the European MCL Network and the German Low Grade Lymphoma Study Group. Blood 111:2385–2387
Hoster E, Dreyling M, Klapper W et al (2008) A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma. Blood 111:558–565
Rosenwald A, Wright G, Wiestner A et al (2003) The proliferation gene expression signature is a quantitative integrator of oncogenic events that predicts survival in mantle cell lymphoma. Cancer Cell 3:185–197
Friche E, Danks MK, Schmidt CA et al (1991) Decreased DNA topoisomerase II in daunorubicin-resistant Ehrlich ascites tumor cells. Cancer Res 51:4213–4218
Deffie AM, Batra JK, Goldenberg GJ (1989) Direct correlation between DNA topoisomerase II activity and cytotoxicity in adriamycin-sensitive and -resistant P388 leukemia cell lines. Cancer Res 49:58–62
Davies SM, Robson CN, Davies SL et al (1988) Nuclear topoisomerase II levels correlate with the sensitivity of mammalian cells to intercalating agents and epipodophyllotoxins. J Biol Chem 263:17724–17729
Asano T, An T, Mayes J et al (1996) Transfection of human topoisomerase II alpha into etoposide-resistant cells: transient increase in sensitivity followed by down-regulation of the endogenous gene. Biochem J 319(Pt 1):307–313
Korkolopoulou P, Vassilakopoulos TP (2004) Topoisomerase IIalpha as a prognostic factor in mantle cell lymphoma. Leukemia 18:1347–1349
Kodet R, Mrhalova M, Krskova L et al (2003) Mantle cell lymphoma: improved diagnostics using a combined approach of immunohistochemistry and identification of t(11;14)(q13;q32) by polymerase chain reaction and fluorescence in situ hybridization. Virchows Arch 442:538–547
van Dongen JJ, Langerak AW, Bruggemann M et al (2003) Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: report of the BIOMED-2 Concerted Action BMH4-CT98-3936. Leukemia 17:2257–2317
Brizova H, Kalinova M, Krskova L et al (2008) Quantitative measurement of cyclin D1 mRNA, a potent diagnostic tool to separate mantle cell lymphoma from other B-cell lymphoproliferative disorders. Diagn Mol Pathol 17:39–50
Lupberger J, Kreuzer KA, Baskaynak G et al (2002) Quantitative analysis of beta-actin, beta-2-microglobulin and porphobilinogen deaminase mRNA and their comparison as control transcripts for RT-PCR. Mol Cell Probes 16:25–30
Gerdes J, Lemke H, Baisch H et al (1984) Cell cycle analysis of a cell proliferation-associated human nuclear antigen defined by the monoclonal antibody Ki-67. J Immunol 133:1710–1715
Woessner RD, Mattern MR, Mirabelli CK et al (1991) Proliferation- and cell cycle-dependent differences in expression of the 170 kilodalton and 180 kilodalton forms of topoisomerase II in NIH-3T3 cells. Cell Growth Differ 2:209–214
Heidebrecht HJ, Adam-Klages S, Szczepanowski M et al (2003) repp 86: a human protein associated in the progression of mitosis. Mol Cancer Res 1:271–279
Argatoff LH, Connors JM, Klasa RJ et al (1997) Mantle cell lymphoma: a clinicopathologic study of 80 cases. Blood 89:2067–2078
Klapper W, Hoster E, Determann O et al (2009) Ki-67 as a prognostic marker in mantle cell lymphoma—consensus guidelines of the pathology panel of the European MCL Network. J Hematop 2:103–111
Heidebrecht HJ, Buck F, Steinmann J et al (1997) p100: a novel proliferation-associated nuclear protein specifically restricted to cell cycle phases S, G2, and M. Blood 90:226–233
Scholzen T, Gerdes J (2000) The Ki-67 protein: from the known and the unknown. J Cell Physiol 182:311–322
Hartmann E, Fernandez V, Moreno V et al (2008) Five-gene model to predict survival in mantle-cell lymphoma using frozen or formalin-fixed, paraffin-embedded tissue. J Clin Oncol 26:4966–4972
Klier M, Anastasov N, Hermann A et al (2008) Specific lentiviral shRNA-mediated knockdown of cyclin D1 in mantle cell lymphoma has minimal effects on cell survival and reveals a regulatory circuit with cyclin D2. Leukemia 22:2097–2105
Acknowledgments
This work was supported by the Internal grant of faculty hospital in Motol no. 9756, Grant GAUK 46/2006/C/2.LF, and the Research project of the Ministry of Health no. 00064203/6704. We thank Dr. W. Klapper and the late Prof. Dr. R. Parwaresh (Department of Hematopathology and Lymph Node Registry, University Hospitals of Schleswig-Holstein, Kiel, Germany) who kindly provided us a sample of the antibody Ki-S2 against TPX2.
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The authors declare that they have no conflict of interest in this study.
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Brizova, H., Kalinova, M., Krskova, L. et al. A novel quantitative PCR of proliferation markers (Ki-67, topoisomerase IIα, and TPX2): an immunohistochemical correlation, testing, and optimizing for mantle cell lymphoma. Virchows Arch 456, 671–679 (2010). https://doi.org/10.1007/s00428-010-0922-8
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DOI: https://doi.org/10.1007/s00428-010-0922-8