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World J Gastroenterol. Jun 14, 2006; 12(22): 3602-3608
Published online Jun 14, 2006. doi: 10.3748/wjg.v12.i22.3602
Roles of syndecan-1, bcl6 and p53 in diagnosis and prognostication of immunoproliferative small intestinal disease
Kim Vaiphei, Neeraj Kumari, Saroj Kant Sinha, Usha Dutta, Birinder Nagi, Kusum Joshi, Kartar Singh
Kim Vaiphei, Neeraj Kumari, Kusum Joshi, Department of Histopathology, PGIMER, Chandigarh, India
Saroj Kant Sinha, Usha Dutta, Birinder Nagi, Kartar Singh, Department of Gastroenterology, PGIMER, Chandigarh, India
Co-first-authors: Neeraj Kumari
Correspondence to: Dr. Kim Vaiphei, No. 127/C, Sector- 24/A, Chandigarh, Pin-160023, India. kvaiphei@gmail.com
Telephone: +91-172-2755140 Fax: +91-172-2744401
Received: December 13, 2005
Revised: February 10, 2006
Accepted: February 18, 2006
Published online: June 14, 2006
Abstract

AIM: To evaluate roles of syndecan-1, bcl6 and p53 in diagnosis and prognostication of immunoproliferative small intestinal disease (IPSID) and to study profiles of kappa (κ) and lambda (λ) light chains and IgA heavy chain.

METHODS: The study consisted of 11 cases of IPSID and similar number of controls which included 11 of normal intestinal mucosa and 11 of high grade B cell lymphoma of ileum. The parameters analyzed included clinical profiles, biochemical and other laboratory investigations, radiologic and histological findings including immunohistochemistry.

RESULTS: All IPSID cases had demonstrable serum IgA heavy chain and heavy mucosal plasma cell infiltration. According to Galian’s histological staging, there were 4 patients with stage A and 7 with stage B. κ and λ light chains were over-expressed in 7 patients; 1 stage A patient had H pylori-positive active gastritis and eradication of H pylori led to disease remission. Stage A biopsies had higher expression for syndecan-1, while stage B had higher expression for bcl6 and p53. Syndecan-1, κ and λ light chains and IgA heavy chain showed inverse relationship with bcl6 and p53. All patients were treated with doxycycline. CHOP regime was added in 5 patients who developed frank lymphoma. Three died of the disease due to extensive organ infiltration.

CONCLUSION: Certain immunomarkers like syndecan-1, κ and λ light chains and IgA heavy chain could be of much help in identifying early stage IPSID. Stage B IPSID showed higher expression for bcl6 and p53 than stage A IPSID. bcl6 and p53 expressions correlated with a more advanced disease stage and aggressive tumour behavior.

Keywords: IPSID; Syndecan-1; bcl6; p53 protein; κ and λ light chains; Alpha heavy chain; H pylori