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Int J Clin Exp Pathol 2013;6(12):2765-2777

Original Article
Epstein-Barr virus infection correlates with the expression of COX-2, p16INK4A and p53
in classic Hodgkin lymphoma

Suhail Al-Salam, Aktham Awwad, Manjusha Sudhadevi, Sayel Daoud, Nico JD Nagelkerke, Antonio Castella, SM Chong, Mouied Alashari

Department of Pathology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Department
of Laboratory Medicine, Tawam Hospital in Affiliation with Johns Hopkins International Medicine, Al Ain, United Arab Emirates; Department of
Pathology, Yong Loo Lin School of Medicine, National University Singapore, Singapore

Received September 20, 2013; Accepted October 5, 2013; Epub November 15, 2013; Published December 1, 2013

Abstract: Classic Hodgkin lymphoma (cHL), a germinal-center related B cell neoplasm in almost all cases, is characterized by scarcity of the
neoplastic Hodgkin/Reed-Sternberg (H/RS) cells. Epstein-Barr virus (EBV) has been shown to affect cell cycle and regulation of apoptosis. In
total, 95 cases of cHL were studied. Five-micrometer sections were prepared and stained with hematoxylin and eosin and
immunohistochemical streptavidin-biotin methods for EBV-LMP-1, COX-2, p53, p16, ki-67 and cleaved caspase-3. In-situ hybridization for EBV
encoded RNA was used to confirm the detection of EBV in H/RS. There were 49 nodular sclerosis, 32 mixed cellularity, 8 lymphocyte-rich, and 6
lymphocyte-depleted subtypes in this series of cases. EBV, COX-2, p16INK4A and p53 were detected in 55% (52/95), 64% (61/95), 62%
(59/95), and 65% (62/95) of the cases respectively. EBV was detected in 62% (38/61), 70% (41/59), and 69% (43/62) of COX2, p16 and p53
positive cases respectively. On the other hand, EBV-non-infected cases of cHL are associated with 59% (20/34), 69% (25/36), and 73% (24/33)
of COX2, p16 and p53 negative cases respectively. In conclusion, EBV infection is associated with the expression of COX-2, p16INK4A and
p53. EBV might be the dominant factor in determining the expression of these three proteins. (IJCEP1309052).

Keywords: Hodgkin lymphoma, Epstein Barr virus, COX-2, P16, P53

Address correspondence to: Dr. Suhail Al-Salam, Department of Pathology, Faculty of Medicine and Health Sciences, United Arab Emirates
University, Al Ain, United Arab Emirates. Tel: 0097137672000 Ext-464; Fax: 0097137671966; E-mail: suhaila@uaeu.ac.ae