Prognostic significance of Ki-67 nuclear proliferative antigen, bcl-2 protein, and p53 expression in follicular and diffuse large B-cell lymphoma |
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Authors: | Dr Marta Llanos Hugo Alvarez-Argüelles Remedios Alemán Juana Oramas Lucio Díaz-Flores Norberto Batista |
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Institution: | (1) Department of Pathology, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain;(2) Department of Internal Medicine, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain;(3) Department of Medical Oncology, Hospital Universitario de Canarias, Ofra s/n, La Laguna, 38320 Santa Cruz de Tenerife, Spain |
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Abstract: | We analyzed 104 patients with non-Hodgkin’s lymphoma, follicular or diffuse large-B-cell-type lymphoma, in order to evaluate
the correlation between clinical characteristics and immunohistochemical parameters. Immunostaining was performed by means
of monoclonal antibodies against Ki-67, bcl-2, and p53 expression. Forty-nine of the patients showed follicular lymphoma.
A high expression of bcl-2 was found in 93%, high expression of p53 in 57%, and low expression of Ki-67 in 96%. Follicular
lymphoma grade III showed a p53 expression (p=0.07) slightly higher than follicular lymphoma grades I and II, not reaching statistical significance. Follicular lymphoma
grades I and II tended to express lower Ki-67 and higher levels of bcl-2 expression than grade III (p=0.06). Fifty-five cases showed diffuse large-B-cell lymphoma. Among them, bcl-2 was absent in 39%, whereas p53 and Ki-67
expression were high in 38%. In the diffuse large-B-cell lymphomas, a high bcl-2 expression correlated with stages III and
IV (p=0.03) and involvement of more than one extranodal area (p=0.03). High Ki-67 expression was also associated to extranodal involvement of more than one area (p=0.03). Overall survival of patients did not show statistically significant differences regarding Ki-67, bcl-2, and p53 tumoral
expression. Prognostic factors for overall survival in the multivariate analysis were age (p=0.02) and LDH (p=0.003). Time to progression was worse among follicular lymphoma with high p53 expression than with mild/moderate p53 expression
(p=0.009). |
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Keywords: | Lymphoma immunohistochemistry bcl-2 p53 Ki-67 prognosis |
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