title: p53 expression is a strong marker of inferior survival in de novo diffuse large B-cell lymphoma and may have enhanced negative effect with MYC coexpression: a single institutional clinicopathologic study.
abstract: OBJECTIVE
  To examine interactions among clinical factors and pathologic biomarkers in predicting the outcome of patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab-based immunochemotherapy.
  
  
  METHODS
  In 85 patients treated at a single institution, clinicopathologic variables were analyzed, including the International Prognostic Index (IPI); germinal/nongerminal center phenotype; MYC, p53, BCL2, Ki-67, and Epstein-Barr virus (EBV) expression; and MYC translocation status.
  
  
  RESULTS
  In univariate analysis, overall survival (OS) was worse for patients with high IPI scores, nongerminal center phenotype, high MYC and p53 expression by immunohistochemistry, and EBV positivity. In multivariable analysis, p53 expression was the strongest prognostic factor (P < .05) independent of IPI and cell of origin. A significant positive association between p53 and MYC expression was found. Moreover, coexpression of p53/MYC had an enhanced negative effect on OS independent of BCL2 expression.
  
  
  CONCLUSIONS
  Immunohistochemical assessment of p53, particularly in combination with MYC, could be useful in identifying a high-risk subgroup of DLBCL.
authors.affiliation: Dept of Pathology, University of Southern California, 1441 Eastlake Ave, NOR 2424E, Los Angeles, CA 90033; isiddiqi@usc.edu.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xie
authors.forename: Mohmad Ajaz
authors.initials: MA
authors.lastname: Bulbul
authors.forename: Lingyun
authors.initials: L
authors.lastname: Ji
authors.forename: Casey M
authors.initials: CM
authors.lastname: Inouye
authors.forename: Susan G
authors.initials: SG
authors.lastname: Groshen
authors.forename: Anil
authors.initials: A
authors.lastname: Tulpule
authors.forename: Dennis P
authors.initials: DP
authors.lastname: O'Malley
authors.forename: Endi
authors.initials: E
authors.lastname: Wang
authors.forename: Imran N
authors.initials: IN
authors.lastname: Siddiqi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000235:genetics / Q000401:mortality* / Q000473:pathology; D008875:Middle Aged; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics*; D000069283:Rituximab; D014178:Translocation, Genetic; D016159:Tumor Suppressor Protein p53 / Q000235:genetics*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D016271:Proto-Oncogene Proteins c-myc; D016159:Tumor Suppressor Protein p53; D000069283:Rituximab
keywords: Diffuse large B-cell lymphoma; MYC immunohistochemistry; P53 immunohistochemistry