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bcl-2 and p53 as novel biomarkers for predicting malignant transformation in chronic osteomyelitis

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MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

A Correction to this article was published on 18 February 2023

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Abstract

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.

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References

  1. Barakat A, Schilling WH, Sharma S, Guryel E, Freeman R (2019) Chronic osteomyelitis: a review on current concepts and trends in treatment. Orthop Trauma. https://doi.org/10.1016/j.mporth.2019.03.005

    Article  Google Scholar 

  2. Kurihara T, Suehara Y, Akaike K, Hayashi T, Okubo T, Kim Y, Saito T (2019) Squamous cell carcinoma arising from chronic osteomyelitis massively expanding into the medullary cavity: a case report. Hum Pathol Case Rep 16:100289. https://doi.org/10.1016/j.ehpc.2019.01.008

    Article  Google Scholar 

  3. Panteli M, Puttaswamaiah R, Lowenberg DW, Giannoudis PV (2014) Malignant transformation in chronic osteomyelitis: recognition and principles of management. J Am Acad Orthop Surg 22(9):586–594. https://doi.org/10.5435/JAAOS-22-09-586

    Article  PubMed  Google Scholar 

  4. Li Q, Cui H, Dong J, He Y, Zhou D, Zhang P, Liu P (2015) Squamous cell carcinoma resulting from chronic osteomyelitis: a retrospective study of 8 cases. Int J Clin Exp Pathol 8(9):10178–101784

    PubMed  PubMed Central  Google Scholar 

  5. Panteli M, Giannoudis PV (2016) Chronic osteomyelitis: what the surgeon needs to know. EFORT Open Rev 1(5):128–135. https://doi.org/10.1302/2058-5241.1.000017

    Article  PubMed  PubMed Central  Google Scholar 

  6. Alami M, Mahfoud M, El Bardouni A, Berrada MS, El Yaacoubi M (2011) Squamous cell carcinoma arising from chronic osteomyelitis. Acta Orthop Traumatol Turc 45(3):144–148. https://doi.org/10.3944/AOTT.2011.2537

    Article  PubMed  Google Scholar 

  7. Baweja P, Monappa V, Krishnanand G (2013) P53 immunohistochemical staining patterns in benign, premalignant and malignant lesions of the oral cavity: a study of 68 cases. J Interdiscipl Histopathol 1(3):113–120. https://doi.org/10.5455/jihp.20130121120725

    Article  Google Scholar 

  8. Binayke A, Mishra S, Suman P et al (2019) Awakening the “guardian of genome”: reactivation of mutant p53. Cancer Chemother Pharmacol 83:1–15. https://doi.org/10.1007/s00280-018-3701-x

    Article  CAS  PubMed  Google Scholar 

  9. Idowu MO, In Dumur CI, In Garrett CT (2015) Molecular oncology testing for solid tumors: a pragmatic approach. Springer. ISBN 978-3-319-16304-8

  10. Mantovani F, Collavin L, Del Sal G (2019) Mutant p53 as a guardian of the cancer cell. Cell Death Differ 26:199–212. https://doi.org/10.1038/s41418-018-0246-9

    Article  PubMed  Google Scholar 

  11. Wang X et al (2017) Clinical effects of p53 overexpression in squamous cell carcinoma of the sinonasal tract: a systematic meta-analysis with PRISMA guidelines. Medicine. https://doi.org/10.1097/MD.0000000000006424

    Article  PubMed  PubMed Central  Google Scholar 

  12. Uma HD (2016) (2016) Bcl-2 family proteins as regulators of cancer cell invasion and metastasis: a review focusing on mitochondrial respiration and reactive oxygen species. Oncotarget. 7(5):5193–5203. https://doi.org/10.18632/oncotarget.6405

    Article  Google Scholar 

  13. Arumugam J, Jeddy N, Ramamurthy A, Thangavelu R (2017) The expression of Bcl-2 in oral squamous cell carcinoma—a review. J Orofac Sci 9:71–74. https://doi.org/10.4103/jofs.jofs_88_16

    Article  CAS  Google Scholar 

  14. Thongsuksai P, Pruegsanusak K, Boonyaphiphat P (2014) Prognostic significance of p16, p53, Bcl-2, and Bax in oral and oropharyngeal squamous cell carcinoma. Asian Biomed 8(2):255–261. https://doi.org/10.5372/1905-7415.0802.287

    Article  Google Scholar 

  15. Deffar K, Khenchouche A, Xing X, Ying L, Ouhida S, Mahnane A (2018) Immunohistochemical expression of p53 and Bcl-2 in Algerian Cervical Carcinoma. Biomed Pharmacol J. https://doi.org/10.13005/bpj/1348

    Article  Google Scholar 

  16. Grace VM, Shalini JV, lekha, T. T., Devaraj, S. N., & Devaraj, H. (2003) Co-overexpression of p53 and bcl-2 proteins in HPV-induced squamous cell carcinoma of the uterine cervix. Gynecol Oncol 91(1):51–58. https://doi.org/10.1016/s0090-8258(03)00439-6

    Article  CAS  PubMed  Google Scholar 

  17. Peng L, Luo Y, Huang X, Li Z (2020) Carcinogenesis and precancerosis transformation of chronic osteomyelitis: 6 cases report and literature review. Med Hypotheses. https://doi.org/10.1016/j.mehy.2020.109643

    Article  PubMed  Google Scholar 

  18. Cierny G 3rd (2011) Surgical treatment of osteomyelitis. Plast Reconstr Surg 127(Suppl 1):190S-204S. https://doi.org/10.1097/PRS.0b013e3182025070

    Article  CAS  PubMed  Google Scholar 

  19. Arshad Z, Lau EJ, Aslam A, Thahir A, Krkovic M (2021) Management of chronic osteomyelitis of the femur and tibia: a scoping review. EFORT Open Rev 1(6):704–715. https://doi.org/10.1302/2058-5241.6.200136

    Article  Google Scholar 

  20. Panteli M, Giannoudis PV (2017) Chronic osteomyelitis: what the surgeon needs to know. EFORT Open Rev 1(5):128–135. https://doi.org/10.1302/2058-5241.1.000017

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic and Traumatology, Sanglah General Hospital, Faculty of Medicine, University of Udayana, Denpasar, Bali, Indonesia

    Hans Kristian Nugraha, I Gede Eka Wiratnaya & Putu Astawa

  2. Deparment of Anatomical Pathology, Sanglah General Hospital, Faculty of Medicine, University of Udayana, Denpasar, Bali, Indonesia

    I Wayan Juli Sumadi

Authors
  1. Hans Kristian Nugraha
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  2. I Gede Eka Wiratnaya
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  3. Putu Astawa
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  4. I Wayan Juli Sumadi
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Contributions

All authors were involved in drafting the article or revising it critically for content, and all authors approved the final version. H.K.N. and I.G.E.W. had access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of its analysis. Study conception and design: H.K.N., and I.G.E.W. Acquisition of data: H.K.N., I.G.E.W., and I.W.J.S. Analysis and interpretation of data: H.K.N., I.G.E.W., and P.A.

Corresponding author

Correspondence to I Gede Eka Wiratnaya.

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Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. Approved by our University Research Ethics Committee, Registration No: 2177/UN14.2.2.VII.14/LP/2019.

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All authors stated that there is no conflict of interest.

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Nugraha, H.K., Wiratnaya, I.G.E., Astawa, P. et al. bcl-2 and p53 as novel biomarkers for predicting malignant transformation in chronic osteomyelitis. Musculoskelet Surg 107, 97–103 (2023). https://doi.org/10.1007/s12306-021-00733-8

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  • DOI: https://doi.org/10.1007/s12306-021-00733-8

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