Prognostic Significance of Bcl-2 and p53 Protein Expressions and Ki67 Proliferative Index in Diffuse Large B-cell Lymphoma

Abstract

Objective: Diffuse large B-cell lymphoma (DLBCL) is a high-grade neoplasm that has heterogeneous properties in clinical, morphological, and immunophenotypic aspects. In the present study the effects of p53, Bcl-2, and Ki67 on prognosis and their relationships with clinical parameters were examined. Materials and Methods: Thirty-five patients who had been diagnosed with nodally located DLBCL at İzmir Atatürk Training and Research Hospital between January 1999 and June 2006 were included in the study. The Ann Arbor classification system was used to determine the stage of the patients. The patients were evaluated according to age, sex, stage, B symptoms, extranodal involvement, and lactate dehydrogenase (LDH) level as well as immunohistochemically. P53 protein and Bcl-2 oncoprotein expressions and Ki67 proliferation index were assessed immunohistochemically. Results: High Bcl-2 expression was found in 9 patients (25.7%), high p53 expression was found in 10 patients (28.6%), and high Ki67 was observed in 23 patients (65.7%). There was no significant correlation between p53 expression, Bcl-2 expression, or Ki67 proliferation index and age, sex, stage, B symptoms, extranodal involvement, LDH level, and overall survival (p>0.05). We did not find a relationship among p53 expression, Bcl-2 expression, Ki67 proliferation index, and prognosis (p>0.05). There was no significant relationship between overall survival and age, sex, stage, B symptoms, extranodal involvement, or LDH level (p>0.05). Our results revealed that Bcl-2 and p53 protein expressions and Ki67 proliferation index have no effect on overall survival of patients with DLBCL.Conclusion: The prognostic importance of p53 and Bcl-2 protein expressions and Ki67 proliferation index in DLBCL, which has biological and clinical heterogeneity, can be understood in a large series of studies that have subclasses and immunohistochemical markers with optimal cut-off values.

Lymphoepithelioma-like breast carcinoma

“…The clinical characteristics of the previous reports are summarised in Table I. Morphologically, tumour necroses were identified in two patients in the Dadmanesh series as well as in five more cases [5,10,15,19,24]. A lobular variant of LELC-B has been reported by some authors [3,4,7,9] associated with LCIS [3,4,7], pagetoid spread [4], or with atypical lobular hyperplasia [9].…”

“…Lymphoepithelioma-like carcinoma (LELC) is a poorly differentiated carcinoma occurring outside the nasopharynx, which displays identical histological features to its nasopharyngeal counterpart. It has been reported in several anatomic sites including breast [3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25], colon [26], esophagus [27], kidney [28], lacrimal gland [29,30], larynx [31], hepatobiliary system [32,33], lungs [34], major and minor salivary glands [35,36,37,38], orbital adnexa [39], prostate [28], skin [40], stomach [41], thymus [42], thyroid [43], trachea [44], ureter [45], urinary bladder [46], uterine cervix [47], vagina [48], and vulva…”

Frequency and Clinical Association of NY-ESO-1 Gene Expression in Diffuse Large B-cell Lymphoma.

“…[15][16] Although survival can be estimated based on clinical parameters (age, LDH levels in serum, extranodal site involvement, disease stage, and immunophenotype B), as well as molecular abnormalities (p53, BCL-2, BCL6, MUM.1 and Ki67), controversy exists regarding their utility as prognostic and survival markers. 17 As a result, it is of paramount importance to find new markers that could be incorporated to determine the prognosis of this disease.…”

“…The mRNA expression levels of the NY-ESO-1 (Hs00265824_m1) and glyceraldehyde 3-phosphate dehydrogenase (GAPDH; Hs00985689) genes were measured using the TaqMan® gene expression assay (Applied Biosystems, Foster City, CA, USA). 19 The GAPDH gene was used as an endogenous control, and each sample was analyzed in triplicate. The relative gene expression levels were calculated by the 2 -ΔΔCt method using Testicular tissue as calibrator.…”

“…It has been used to diagnose and assess the prognosis of various types of cancer, [8][9][10] and its expression is restricted solely to immune-privileged germinal cells, which are the most immunogenic of this family. 11,12 It is abnormally expressed in a variety of cancers and is associated with the unfavorable evolution of multiple myeloma 16,17 and non-small cell lung cancer. [13][14] Our group analyzed the NY-ESO-1 gene expression levels of patients with DLBCL using quantitative in real-time (qRT-PCR) and demonstrated that there is a relationship between the clinical parameters and a lower survival rate, the detection of NY-ESO-1 by qRT-PCR could be useful for disease prognosis and follow-up…”