Expression of Keap1 and Nrf2 in diffuse large B‑cell lymphoma and its clinical significance

The present study investigated the expression and clinical significance of kelch-like ECH-associated protein 1 (Keap1) and nuclear factor erythroid-2-related factor-2 (Nrf2) expression in diffuse large B-cell lymphoma (DLBCL). These proteins were detected by immunohistochemistry in 39 DLBCL cases and 17 cases of reactive lymph node hyperplasia, and their association with the clinicopathological features of DLBCL patients was analyzed. In DLBCL, the percentage of cells with positive staining for Keap1 and Nrf2 was 46.2 and 35.9%, respectively, which was significantly higher than that in reactive lymph node hyperplasia (17.7 and 5.9%, respectively). There was no correlation between Keap1 and Nrf2 expression according to a Spearman rank correlation analysis (r=0.272; P>0.05). Keap1 and Nrf2 expression was associated with the international prognostic index and Ann-Arbor clinical stage (P<0.05), and Keap1 and Nrf2 expression was higher in DLBCL patients with stage III–IV (68.4 and 52.6%, respectively) compared with in those with stage I–II (25.0 and 20.0%, respectively). The aberrant expression of Keap1 and Nrf2 in DLBCL suggests that these factors may have crucial roles in the development and progression of the disease, and may therefore be used as prognostic indicators.