Expressions of Cox-2, Bcl-2 and LMP-1 in Classical Hodgkin's Lymphoma, and Their Relationship with Prognosis
G Inan, S Bircan, N Kapucuoglu, N Karahan, M Ciris. Suleyman Demirel University Faculty of Medicine, Isparta, Turkey
Background: The importance of Cox-2 and Bcl-2 in the pathogenesis of classical Hodgkin's lymphoma (cHL) is not known exactly. The aim of this study is to examine Cox-2, Bcl-2 and LMP-1 expressions in cHL patients and to investigate their association with clinicopathological parameters and prognosis.
Design: The study included 40 cHL cases including 29 mixed cellularity cHL (MCcHL), 11 nodular sclerosis cHL (NScHL). Tissue microarrays (TMA) blocks were prepared manually from formalin fixed paraffin embedded tissues. Cox-2, Bcl-2 and LMP-1 antibodies were performed to TMA section immunohistochemically. The immunoexpression was evaluated only tumoral Hodgkin and Reed-Sternberg cells. Clinical data of the cases were obtained from the medical files, and for clinical staging Ann-Arbor system was used.
Results: In the study, there was a statistically significant difference between subtypes of cHL in relation to clinical stage and gender. The cases with the advance stage (stage III-IV) and male gender were significantly higher in MCcHL in contrast to NScHL (p=0.031, p<0.001, respectively). Cox-2 were positive in 20 cases (50%) of cHL, and Cox-2 negative patients were significantly higher in male gender (p=0.041).Nine patients (81,8%) of NScHL and 11 patients (37,9%) of MCcHL were Cox-2 positive, which was significantly different (p=0.031). There was a negative correlation between Cox-2 expression and clinical stage (p=0.042, r=-0.328). Although it was not significant, Cox-2 negative cases tend to be higher in advance stage. Bcl-2 and LMP-1 were positive in 14 (35%) and 23 (57,5%) of cHL patients, respectively. LMP-1 positivity was significanly higher in MCcHL subtype (%75,9) (p<0.001). By Kaplan Meier log rank test, we found that the advance stage (stage III-IV) and Cox-2 negativity were poor prognostic parameters regarding overall survival (p=0,004, p=0,010, respectively). However, significant independent prognostic parameter was not found by Cox regression analysis including Cox-2, Bcl-2 and LMP-1 expressions, and stage.
Conclusions: In conclusion, our study confirm the prognostic value of clinical stage in cHL patients. However, these results may also consider that Cox-2 negativity may be one of the poor prognostic parameters in cHL.
Wednesday, March 24, 2010 9:30 AM
Poster Session V # 199, Wednesday Morning