The Expression And Significance Of Survivin, Ki67, Cyclin D3, And P27 In Cutaneous Extranodal NK/T Cell Lymphoma, Nasal Type

Background and Objective The pathogenesis of cutaneous extranodal nasal type NK/T cell lymphoma is complicated. It was hypothesized that the tumor was relevant to the abnormal proliferation and apoptosis of lymphocytes to some extent. A retrospective study was carried out in 15 cases of cutaneous extranodal nasal type NK/T cell lymphoma clinicalpathologically. The expression of Survivin, Ki67, Cyclin D3 and P27 was detected in order to find if there are some relationships among the biomarkers and the clinicalpathological features of cutaneous extranodal NK/T cell lymphoma, nasal type.Materials and Methods Fifteen cases of cutaneous extranodal nasal type NK/T cell lymphoma were selected from the archives of Pathologic Laboratory of Dermatological Department and Pathological Department, West China Hospital of Sichuan University from 1984 to 2006. The related clinical and follow-up data were collected and all the histopathological slides were reviewed. The antibodies used for immunohistochemical staining were Survivin, Ki67, Cyclin D3 and P27. Fifteen cases were devied into groups according to the number of skin lesions, the size of the neoplastic cells, the number of mitoses and the necrosis respectively. The correlations were analyzed among the groups and the expression of the biomarkers.. Results (1) Clinical manifestations: The mean age and the median age of 15 cases of cutaneous extranodal nasal type NK/T cell lymphoma was 28.7 years and 28 years respectively, and the high incidence was from 30 to 39 years. The ratio of male/female is 2:1. Patients generally presented with nodules, ulcers and/or erythemas. Systemic symptoms were found in 81.8% of all the cases, in which fever was the most common. (2) Histopathology: Pathologic changes were mainly located in the dermis. Most of the atypical lymphocytes were medium to large cells. Angioinvasion was found in 80% of the cases, presenting as angiocentricity and fibroid necrosis of the blood vessels. Necrosis was found in 73.3% of the cases. The epidermotropism and appendix tropism of the tumor cells were found in 33.3% and 66.7%, separately. (3) The expression of Survivin: Survivin expressed in 73.3% of the cases and the rate of positive cells was 23.97%±18.35% in average. The expression of Survivin didn't show any correlation with the number of skin lesions, the size of the neoplastic cells, mitoses and necrosis. (4) The expression of Ki67: Ki67 expressed in all the cases, the rate of positive cells was 41.20%±19.52% in average. The expression of Ki67 was significantly higher in the group of mitoses＞2/hps than that of＜2/hps, but had no correlation with the number of skin lesions, the size of the neoplastic cells and necrosis. (5) The expression of Cyclin D3: Cyclin D3 expressed in 86.7% of the cases, the rate of positive cells was 19.80%±14.38% in average. The expression of Cyclin D3 was significantly higher in the group of mitoses＞2/hps than that of＜2/hps, but had no correlation with the number of skin lesions, the size of the neoplastic cells and necrosis. (6) The expression of P27: P27 expressed in 93.33% of the cases, the rate of positive cells was 46.54%±16.94% in average. The expression of P27 had no correlation with the number of skin lesions, the size of the neoplastic cells, mitoses and necrosis. (7) Correlation analysis: The expressions of Survivin, Ki67, Cyclin D3 and P27 had no correlation with each other by Pearson Correlation analysis.Conclusions Cutaneous extranodal nasal type NK/T cell lymphoma is a cutaneous lymphoma with distinctive clinicopathological features that mainly involved the dermis. The prognosis is poor. Survivin, Ki67, Cyclin D3 and P27 expressed highly in this tumor. The higher expression of Ki67 and Cyclin D3 in the cases with more mitoses suggests that these cases may have higher proliferative activity. We did not find any correlation among the expression of Survivin, Ki67, Cyclin D3 and P27 in this study.