Expression of COX-2, survivin, Ki-67, BCL-2, CD3 in diffuse large B-cell lymphoma subtypes and their effects on prognosis

SUMMARY`?Expression of COX-2, survivin, Ki-67, BCL-2, CD3 in diffuse large B-celllymphoma subtypes and their effects on prognosis `?Dr Ülkü KüçükDokuz Eylül University Medical Faculty Pathology Departmentnciraltı/ zmirPurpose : Recent studies demonstrate that COX-2 and survivin expressions arepoor prognostic factors in diffuse large B-cell lymphomas. In our study, weinvestigated CD3, bcl-2, Ki-67, COX-2 and survivin expressions and their role on theprognosis of germinal center B-cell like, non-germinal center B-cell like andunclassified subtypes of diffuse large B-cell lymphoma.Materials and methods: 50 patients who had diagnosis of diffuse large B-celllymphoma and clinical survival data adtmitted between 1990-2006 in Dokuz EylülUniversity Medical Faculty Hospital were included in this study. The diagnosis isconfirmed by CD20 immunopositivity. In these patients; CD10 (+) and/or bcl-6 (+),MUM-1 (-) patients were diagnosed as germinal center B-cell like, whereas thosewith MUM-1 (+), CD10 and bcl-6(-) as well as CD10 (-), bcl-6 and MUM-1 (+) as non-germinal center B-cell like. The unclassified group consisted of the patients who werenegative with all three immunostains. With this method the patients were divided inthree subtypes; germinal center B-cell like (n:16), non- germinal center B-cell like(n:26) and unclassified (n:8). In these subgroups, we investigated CD3, COX-2,survivin, Ki-67 and bcl-2 expressions by immunohistochemistry and their roles onprognosis.Results: The study group comprised 50 patients with DLBCL, including 27 (54%)males and 23 (46%) females. Tha patients? ages ranged from 17 to 95 years (mean57.6). Median follow-up was 52 months (range, 10-160).With Long Rank analysis, survival is significantly better in the patients over 65years old and in women (p:0,03 and p:0,05). There are no significant effects of theother factors on survival. With Cox regression analysis; older age (p:0.001), gender(p:0,07) and the subtypes of diffuse large B-cell lymphomas (p:0,005) are significantlyeffective on survival. With Chi-square analysis; no significant difference in expressionof COX-2, survivin, Ki-67 and CD3 between subtypes of diffuse large B-celllymphoma.Conclusion: We found that, age, gender and subtypes of diffuse large B-celllymphoma over effective on overall survival. Although it is not statistically significantthe intensive inflamatuar reaction in the tumor may be effective on survival. Betweendiffuse large B-cell lymphoma subtypes there were no difference in expression ofCOX-2, survivin, Ki-67, bcl-2 and CD3. It appears that COX-2, survivin, Ki-67, bcl-2and CD3 are not responsible for the survival difference among subtypes of diffuselarge B-cell lymphoma. There might be some other mechanisms and furtherinvestigations need to explain prognostic difference between subtypes of diffuselarge B-cell lymphoma.Key word: Diffuse large B-cell lymphoma, germinal center B-cell like, nongerminalcenter B-cell like, COX-2, survivin, bcl 2, ki-67, CD3