The Profile of P63 Expression and Epstein-Barr-Encoded RNA (EBER) Distribution in Primary Central Nervous System Lymphoma: A Retrospective Bi-center Study

Abstract

Background and Aims: Primary central nervous system lymphoma (PCNSL) is a type of lymphoma occurring around 0.5 – 1.2% of all intracranial neoplasms. However, recent epidemiological research shows a threefold increase in cases. The Epstein-Barr virus (EBV) and PCNSL are both associated with immunosuppression or immunodeficiency, which are often found to have a significant relationship. Moreover, the TP63 mutation is associated with a poor prognosis. Settings and Design: This is a descriptive study to assess the expression of TP63 and EBER on PCNSL and present the characteristics of the disease. The study was conducted on 25 cases from two health centers with the most cases of brain tumors in Indonesia (Siloam Hospital Lippo Village and Cipto Mangunkusumo National General Hospital) from 2014 to 2018. Four pathologists performed the P63 expression and EBER-1 examinations. Statistical Analysis: Descriptive analyses were done using frequencies and percentages for the data. Potential association of antibody expression and lymphoma subtypes were analyzed using Chi-square. Results: Of a total of 25 patients, 13 (52.0%) were male, ranging from age 30 – 79, with an average of 57.6 years old, located mainly in the frontal lobe in 8 patients (32.0%). Further analysis revealed positive P63 results in 20 cases (80.0%), while the EBER test was negative for all 25 patients. Further analysis with the software SPSS 25 proves that P63 expression is not associated with germinal center B-cell type (GCB) or non-GCB type (p-value 0,87). Neither P63 have any association with Ki67 with a p-value of 1.00. Conclusions: There is a possibility that PCNSL cases in Indonesia are not associated with Epstein-Barr virus infection, but most patients will have a poor prognosis as indicated by P63 expression.