Clinicopathological analysis of primary central nervous system lymphoma in patients with or without AIDS

Abstract Background AIDS-related primary central nervous system lymphoma (AR-PCNSL) differs from immunocompetent-primary central nervous system lymphoma (IC-PCNSL) in certain features. The main objective of this study was to investigate the differences in clinicopathological features between AR-PCNSL and IC-PCNSL. Methods Thirty-seven AR-PCNSL patients and thirty IC-PCNSL patients were included. hematoxylin & eosin staining; immunohistochemical detection using CD20, Bcl-2, Bcl-6, p53, C-MYC, Ki67, and METTL3 antibodies; and Epstein–Barr encoding region (EBER) in situ hybridization were performed. Results All of the observed patients were classified as the DLBCL histological type. AR-PCNSL were younger (37.7 vs. 60.5 years) and had a higher likelihood of being male (86.5% vs. 63.3%) than non-AIDS patients were. Elevated LDH and low sugar content in cerebrospinal fluid (CSF) were more common among AR-PCNSL. The expression levels of METTL3, Bcl-2 and p53 expressions were significantly higher in AR-PCNSL patients than in PCNSL patients without AIDS. In contrast, AR-PCNSL patients exhibited lower levels of Bcl-6 expression. AR-PCNSL patients were more likely to be positive for EBER, accounting for 81.1% of these patients. Furthermore, we also found that the expression of METTL3 was lower in GCB-like DLBCL (n=7) than in ABC-like DLBCL (n=32) in AR-PCNSL (p=0.041); however, in IC-PCNSL patients, the expression of METTL3 was not significantly different between GCB-like DLBCL and ABC-like DLBCL (p=0.710). Conclusions Our study of Chinese AR-PCNSL and IC-PCNSL patients revealed new findings, indicating that METTL3, Bcl-2 and p53 were increased in AR-PCNSL patients compared to IC-PCNSL patients and that METTL3 was higher in ABC-like DLBCL patients than in GCB-like DLBCL in AR-PCNSL patients, suggesting a notable distinction in the pathological characteristics between PCNSL patients with or without AIDS.