Clinicopathological implications of immunohistochemical expression of TBX21, CXCR3, GATA3, CCR4, and TCF1 in nodal follicular helper T-cell lymphoma and peripheral T-cell lymphoma, not otherwise specified

• Published in: Journal of pathology and translational medicine Vol. 58; no. 2; pp. 59 - 71
• Main Authors: Han, Bogyeong, Lim, Sojung, Yim, Jeemin, Song, Young Keun, Koh, Jiwon, Kim, Sehui, Lee, Cheol, Kim, Young A, Jeon, Yoon Kyung
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Pathologists, Korean Society for Cytopathology 01-03-2024; The Korean Society of Pathologists/The Korean Society for Cytopathology; Korean Society of Pathologists & the Korean Society for Cytopathology; 대한병리학회
• Subjects: angioimmunoblastic t-cell lymphoma; angioimmunoblastic-type; Cells; Chemokines; Classification; Cloning; Gene expression; Genotype & phenotype; Kinases; Lymphocytes; Lymphoma; Medical prognosis; nodal peripheral t-cell lymphoma of tfh phenotype; nodal t-follicular helper (tfh) cell lymphoma; not otherwise specified; Original; peripheral t-cell lymphoma; Survival analysis; Transcription factors; 병리학; United Kingdom > UK; Ann Arbor Michigan; United States > US; Angioimmunoblastic T-cell lymphoma; Nodal peripheral T-cell lymphoma of TFH phenotype; Nodal T-follicular helper (TFH) cell lymphoma, angioimmunoblastic-type; Nodal T-follicular helper (TFH) cell lymphoma, not otherwise specified; Peripheral T-cell lymphoma, not otherwise specified
• ISSN: 2383-7837; 2383-7845
• DOI: 10.4132/jptm.2024.01.04

The classification of nodal peripheral T-cell lymphoma (PTCL) has evolved according to histology, cell-of-origin, and genetic alterations. However, the comprehensive expression pattern of follicular helper T-cell (Tfh) markers, T-cell factor-1 (TCF1), and Th1- and Th2-like molecules in nodal PTCL is unclear.
Eighty-two cases of nodal PTCL were classified into 53 angioimmunoblastic T-cell lymphomas (AITLs)/nodal T-follicular helper cell lymphoma (nTFHL)-AI, 18 PTCLs-Tfh/nTFHL-not otherwise specified (NOS), and 11 PTCLs-NOS according to the revised 4th/5th World Health Organization classifications. Immunohistochemistry for TCF1, TBX21, CXCR3, GATA3, and CCR4 was performed.
TCF1 was highly expressed in up to 68% of patients with nTFHL but also in 44% of patients with PTCL-NOS (p > .05). CXCR3 expression was higher in AITLs than in non-AITLs (p = .035), whereas GATA3 expression was higher in non-AITL than in AITL (p = .007) and in PTCL-Tfh compared to AITL (p = .010). Of the cases, 70% of AITL, 44% of PTCLTfh/ nTFHL-NOS, and 36% of PTCL-NOS were subclassified as the TBX21 subtype; and 15% of AITL, 38% of PTCL-Tfh/nTFHL-NOS, and 36% of PTCL-NOS were subclassified as the GATA3 subtype. The others were an unclassified subtype. CCR4 expression was associated with poor progression-free survival (PFS) in patients with PTCL-Tfh (p < .001) and nTFHL (p = .023). The GATA3 subtype showed poor overall survival in PTCL-NOS compared to TBX21 (p = .046) and tended to be associated with poor PFS in patients with non-AITL (p = .054).
The TBX21 subtype was more prevalent than the GATA3 subtype in AITL. The GATA3 subtype was associated with poor prognosis in patients with non-AITL and PTCL-NOS.