Cdc7 and Mcm2 expression as markers for the proliferation and prognosis of diffuse large B cell lymphoma

Objective: To assess the proliferative activity of diffuse large B cell lymphoma (DLBCL) using immunohistochemistry (IHC) and real-time polymerase chain reaction of Cdc7 and Mcm2 and to explore their potential value in predicting prognosis. Methods: From Jan 2008 to Jan 2010, the clinical characteristics of 60 DLBCL patients were collected using IHC to assess the expression of Cdc7 and Mcm2. A statistical analysis was conducted on the association of Cdc7 and Mcm2 with the clinicopathologic characteristics of DLBCLs. Results: In the univariate analysis, the 2-year overall survival rate of the patients with positive Cdc7 expression was 41%, and the patient with negative Cdc7 expression was 73%, (P < 0.05). The 2-year overall survival rate of the patients with positive Mcm2 expression was 25%, and the patients with negative Mcm2 expression was 75% (P < 0.05). The clinical data were as follows: ECOG performance status (0-1 vs. 2) (76.6% vs. 23.4%); Ann Arbor stage (I-II vs. III-IV) (65.0% vs. 35.0%); IPI (0-1 vs. ≥ 2) ( 78.3% vs. 21.7%); LDH level (normal vs. abnormal) (70.0% vs. 30.3%); radiotherapy only vs. chemotherapy combined with radiotherapy (41.7% vs. 58.3%); and GCB subtype vs. non-GCB subtype (53.3% vs. 46.7%). ECOG performance status, Ann Arbor stage, International prognostic index (IPI), LDH level, therapy model, and histological type were found to be the prognostic factors associated with the overall survival in DLBCL. The difference in 2-year overall survival rates between the different clinical indicators were significant. The patients with Cdc7- and Mcm2-positive DLBCL had a higher stage of disease than patients with Cdc7- and Mcm2-negative DLBCL. The patients with Cdc7- and Mcm2-positive DLBCL had higher IPI of disease than patients with Cdc7- and Mcm2-negative DLBCL. Conclusion: IPI, treatment, and different cell derivation were prognostic factors. Furthermore, poor disease specific survival is observed in DLBCL patients with high-level Cdc7 and Mcm2 expression.