SUMMARY:Absence of a reliable method for determining the level of c-myc expression has impeded the analysis of its biological and clinical relevance in tumors. We have standardized the conditions for a real-time reverse transcription polymerase chain reaction analysis for c-myc expression, including the selection of an endogenous reference (18S rRNA), the adequate number of measurements for each sample (2 cDNA in triplicate), and suitable controls for determining inter-and intrarun variability (standard curve and calibrator). Subsequently, in a series of 56 non-Hodgkin's lymphomas, we analyzed the expression of c-myc mRNA, using real-time reverse transcription polymerase chain reaction, and of other functionally related proteins (bcl-6, p27, cyclin D3, and p53). As expected, all eight Burkitt's lymphoma cases analyzed had high levels of c-myc mRNA expression compared with that observed in reactive lymphoid tissue. There was a wider range of expression in diffuse large B-cell lymphoma, with 30% (15 of 48) of cases overexpressing c-myc. This overexpression was largely independent of c-myc translocations (4 of 5), as demonstrated by fluorescence in situ hybridization. In this large B-cell lymphoma series, a high level of c-myc expression predicted lower survival probability, irrespectively of the International Prognostic Index risk group classification. A slightly increased frequency of p53 inactivation was observed in the cases with c-myc overexpression, which suggests a growth advantage in lymphomas with concurrent deregulation of c-myc and p53. In addition, a moderate increase in bcl-6 protein expression was observed in the c-myc-positive cases, suggesting the existence of a complex interrelationship between these two genes. These findings suggest that c-myc may play a relevant role in the pathogenesis of a subset of large B-cell lymphoma and suggest the existence of additional regulatory mechanisms of c-myc expression to c-myc rearrangements. (Lab Invest 2003, 83:143-152).
C-myc is a multifunctional gene involved in important cellular processes, such as cell proliferation, differentiation, and apoptosis. c-myc targets include critical genes involved in growth, the cell cycle, signaling, and adhesion (eg, cyclin D2, cyclin D3, DP1, p27 KIP1 , p21 CIP1 , AKT, Cul-1, TGFR-2, CDC25C, API2, BclII) (Coller et al, 2000;Eischen et al, 2001;Guo et al, 2000;Nasi et al, 2001;Neiman et al, 2001;Nesbit et al, 2000;O'Hagan et al, 2000;Schuhmacher et al, 2001).Although c-myc gene was initially described as being involved in t(8;14) in Burkitt's lymphoma (BL), overexpression of c-myc has been found in other solid tumors such as breast, prostate, and gastrointestinal carcinomas and in melanoma. In these neoplasias, c-myc expression has been shown to be dependent on amplifications of the gene or to be derived from deregulation of upstream genes in the c-myc pathway, such as BRCA1, PTEN, and -catenin/APC (Nesbit et al, 1999). In addition, N-myc has been implicated in the pathogenesis of neuroblastomas (Fulda et al, 1999).c-myc ...