THE ASSOCIATION OF BCL2 EXPRESSION WITH PROLIFERATION INDEX Ki67 AND CLINICOPATHOLOGY ASPECT OF DIFFUSE LARGE B-CELL LYMPHOMA

Abstract

Background

Diffuse Large B-cell Lymphoma (DLBCL) is the most common lymphoma. It has various histological patterns, grades, and poses challenges in therapy and prognosis The prognosis of DLBCL is determined by several factors, including immunophenotyping and genetics involving the BCL2 protein This study aims to determine the correlation between BCL2 expression and clinicopathological factors including age, gender, histopathological variants, and proliferation index Ki67 in DLBCL.

Method

This study was an analytical observational study with a cross-sectional study involving 50 cases of DLBCL at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar. BCL2 expression was evaluated by immunohistochemical staining and its expression was classified into positive and negative. A chi-square test was done to analyze the relationship between BCL2 expression with age, gender, morphology variant, and proliferation index Ki67 of DLBCL. Significance was determined at p<0.05.

Result

In this study, a total of 25 (75.8%) out of 33 cases of male patients had positive BCL2 expression, in contrast to female patient samples who showed more negative BCL2 examples. A total of 27 cases (69.2%) of all cases with high Ki67 index proliferation showed BCL2 positive. Bivariate analysis showed a significant relationship between gender (p=0.005) and Ki67 proliferation index (p=0.047) with BCL2 expression. There was no significant association between BCL2 expression with age and morphology variant.

Conclusion

There is a significant association between BCL2 with Ki67 expression and the clinicopathological aspect of gender in DLBCL. It provides additional prognostic information in conjunction with other clinicopathological parameters. It also can be considered to use Ki67 as one of the indicators of prognosis factors in DLBCL cases and considered as a substitute for BCL2 as one of the markers of DLBCL progressivity at Prof. Dr.I.G.N.G Ngoerah Hospital.