Lam LT et al. reported that activated B-cell diffuse large B-cell lymphoma (ABC-DLBCL) had higher level of STAT3 mRNA than that in GCB-DLBCL. Detection with immunohistochemistry  showed that slightly more cases with high nuclear expression of STAT3 were observed in the non-GCB DLBCL group and the high expression rates were 12.5% and 32.4% in GCB and non-GCB subtypes, respectively. However, no statistical significance was found. This is most likely due to the small sample size. Our study showed that the frequency of high nuclear expression of STAT3 in DLBCL was 25.7% with 12.5% in GCB subgroup and 32% in non-GCB subgroup, but not reaching significance (P = 0.061).
Lam LT et al.  also demonstrated that high STAT3 expression in ABC-DLBCL patients correlated with inferior overall survival, but not with GCB-DLBCL patients. However, STAT3-high and STAT3-low subsets within ABC-DLBCL did not differ in prediction of overall survival. Our study showed that high nuclear expression of STAT3 in DLBCL possibly correlated with poor overall survival, especially in patients receiving CHOP regimen. This poor outcome may be explained at least in part by the multiple cellular functions of STAT3, which is a critical component of diverse signal transduction pathways[15, 17, 18]. STAT3 regulates the expression of a number of genes (e.g. survivin, bcl-xl, mcl-1) that modulate cell survival, differentiation, and proliferation (e.g. c-myc, cyclin D1, p21, cyclin E), invasion and metastasis (e.g. matrix metalloproteinase-9 and 2), and angiogenesis (e.g. vascular endothelial growth factor) [11, 20, 21]. STAT3 can restrain anti-tumour immune responses [22–27] and regulate key cancer-promoting inflammatory mediators, which can initiate or promote oncogenic transformation, and genetic and epigenetic changes in malignant cells [28, 29].
Our study also demonstrated the possibility of using immunohistochemistry to detect STAT3 expression in routine pathologic specimens, which may enable us conveniently to identify DLBCL cases with poor clinical outcome, and subsequently guides us to adopt more intensive treatment for those patients.
Since STAT3 plays a critical role in tumor initiation and progression, inhibition of STAT3 activation would be an effective approach for cancer prevention and treatment. Our findings may provide a basis for the application of STAT3 inhibitors in the future.