bcl-2 and p53 as novel biomarkers for predicting malignant transformation in chronic osteomyelitis
Hans Kristian Nugraha1, I Gede Eka Wiratnaya2, Putu Astawa1
1Department of Orthopaedic and Traumatology, Sanglah General Hospital, Faculty of Medicine, University of Udayana, Denpasar, Bali, Indonesia.
Purpose:
To find whether B-cell lymphoma 2 (bcl-2) and p53 proteins could be used as parameters to detect malignant transformation of chronic osteomyelitis. We also attempted to determine whether they could be used to differentiate between secondary squamous cell carcinoma (SCC) resulting from chronic osteomyelitis, and primary cutaneous squamous cell carcinoma.
Methods:
Retrospective study was conducted during 5 years period, resulting in 7 patients in each group: secondary squamous cell carcinoma arising from chronic osteomyelitis, primary cutaneous squamous cell carcinoma, and chronic osteomyelitis patients. Immunohistochemistry staining with bcl-2 and p53 was performed with the pathologist blinded to the sample groups.
Results:
Contingency coefficient test was performed to assess the correlation between the biomarker status (bcl-2 and p53) and the case groups. Significant moderate correlations of bcl-2 and p53 were found between groups of chronic osteomyelitis and squamous cell carcinoma arising from chronic osteomyelitis in terms of malignant transformation (p = 0.005 for bcl-2 and p = 0.031 for p53). Insignificant correlations of bcl-2 and p53 expression were found between primary cutaneous squamous cell carcinoma and secondary squamous cell carcinoma arising from chronic osteomyelitis group (p = 0.577).
Conclusions:
The expression of bcl-2 and p-53 is significantly correlated with chronic osteomyelitis malignant transformation into squamous cell carcinoma.
