Dinand Veronique, Malik Ajay, Unni Rajani, Arya Laxman S, Pandey R M, Dawar Ramesh
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Pediatr Blood Cancer. 2008 Feb;50(2):280-3. doi: 10.1002/pbc.21204.
This study was conducted to assess the clinical and prognostic significance of lack of CD15 expression, proliferative index (PI), and expression of tumor suppressor protein p53 in pediatric classical Hodgkin lymphoma (CHL).
Pre-treatment lymph node (LN) biopsies were studied by immunohistochemistry for immunophenotyping of the lymphoma and with Ki-67 (PI) and p53 antibodies. Expression of CD15 antigen on the Hodgkin and Reed-Sternberg (H-RS) cells, proliferation, and apoptosis parameters were correlated with clinical stage, response to chemotherapy alone, overall (OS) and failure-free survival (FFS).
One hundred and twenty-one children with CHL were studied. Expression of Ki-67 and p53 in H-RS cells was seen in 100% and 89.9% of the cases, respectively. Loss of CD15 expression, seen in 12 (9.9%) cases, was significantly associated with p53 negativity and was an independent prognostic factor for poor OS and poor FFS. PI </= 74% was an independent prognostic factor for poor FFS.
Loss of CD15 expression in CHL might be related to p53 dysregulation. High PI in HL might reflect a high level of endomitosis within tumor cells, and could lead to higher sensitivity to chemotherapy. Low pre-treatment PI and lack of CD15 expression were found to be predictive factors for poor FFS in pediatric CHL.
本研究旨在评估儿童经典型霍奇金淋巴瘤（CHL）中CD15表达缺失、增殖指数（PI）及肿瘤抑制蛋白p53表达的临床及预后意义。
采用免疫组织化学方法对预处理的淋巴结（LN）活检标本进行研究，以对淋巴瘤进行免疫表型分析，并使用Ki-67（PI）和p53抗体。霍奇金和里德-斯腾伯格（H-RS）细胞上CD15抗原的表达、增殖及凋亡参数与临床分期、单纯化疗反应、总生存期（OS）和无失败生存期（FFS）相关。
对121例儿童CHL患者进行了研究。H-RS细胞中Ki-67和p53的表达分别见于100%和89.9%的病例。12例（9.9%）病例出现CD15表达缺失，与p53阴性显著相关，是OS不良和FFS不良的独立预后因素。PI≤74%是FFS不良的独立预后因素。
CHL中CD15表达缺失可能与p53失调有关。HL中高PI可能反映肿瘤细胞内高倍体有丝分裂水平，并可能导致对化疗更高的敏感性。发现预处理时低PI和CD15表达缺失是儿童CHL中FFS不良的预测因素。
