{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:29:45Z","timestamp":1790958585118,"version":"4.1.0"},"reference-count":61,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["pathsocjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pathology CR"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Diffuse large B\u2010cell lymphoma (DLBCL) is a clinically heterogeneous entity, in which the first\u2010line treatment currently consists of an immuno\u2010chemotherapy regimen (R\u2010CHOP). However, around 30% of patients will not respond or will relapse. Overexpression of c\u2010MYC or p53 is frequently found in DLBCL, but an association with prognosis remains controversial, as for other biomarkers previously linked with DLBCL aggressivity (CD5, CD23, or BCL2). The aim of this study was to explore the expression of these biomarkers and their correlation with outcome, clinical, or pathological features in a DLBCL cohort. Immunohistochemical (c\u2010MYC, p53, BCL2, CD5, and CD23), morphological (\u2018starry\u2010sky\u2019 pattern [SSP]), targeted gene panel sequencing by next\u2010generation sequencing (NGS), and fluorescence <jats:italic>in situ<\/jats:italic> hybridisation analyses were performed on tissue microarray blocks for a retrospective cohort of 94 R\u2010CHOP\u2010treated <jats:italic>de novo<\/jats:italic> DLBCL. In univariate analyses, p53 overexpression (p53<jats:sup>high<\/jats:sup>) was associated with unfavourable outcome (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.04) and with c\u2010MYC overexpression (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.01), whereas c\u2010MYC overexpression was linked with an SSP (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004), but only tended towards an inferior prognosis (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.06). Presence of a starry\u2010sky morphology was found to be correlated with better survival in p53<jats:sup>high<\/jats:sup> DLBCL (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.03) and\/or c\u2010MYC\u2010positive DLBCL (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002). Furthermore, NGS data revealed that these three variables were associated with somatic mutations (<jats:italic>PIM1<\/jats:italic>, <jats:italic>TNFRSF14<\/jats:italic>, <jats:italic>FOXO1<\/jats:italic>, and <jats:italic>B2M<\/jats:italic>) involved in B\u2010cell proliferation, survival, metabolism, and immune signalling. Taken together, these results show that the SSP pattern seems to be a protective factor in high\u2010risk DLBCL subgroups and highlight cell death as a built\u2010in failsafe mechanism to control tumour growth.<\/jats:p>","DOI":"10.1002\/cjp2.223","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T02:56:11Z","timestamp":1628564171000},"page":"604-615","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["<scp>c\u2010MYC<\/scp> and p53 expression highlight starry\u2010sky pattern as a favourable prognostic feature in <scp>R\u2010CHOP<\/scp>\u2010treated diffuse large B\u2010cell lymphoma"],"prefix":"10.1002","volume":"7","author":[{"given":"Antonin","family":"Bouroumeau","sequence":"first","affiliation":[{"name":"Department of Pathology Grenoble\u2010Alpes University Hospital  Grenoble France"},{"name":"Institute for Advanced Biosciences INSERM U1209\/CNRS UMR 5309\/Grenoble\u2010Alpes 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