Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada.
Cancer Cytopathol. 2010 Jun 25;118(3):166-72. doi: 10.1002/cncy.20075.
MIB-1 proliferation index (PI) has proven helpful for diagnosis and prognosis in non-Hodgkin lymphomas (NHLs). However, validated cutoff values for use in fine-needle aspiration (FNA) samples are not available. We investigated MIB-1 immunocytochemistry as an ancillary technique for stratifying NHL and attempted to establish PI cutpoints in cytologic samples.
B-cell NHL FNA cases with available cytospins (CS) MIB-1 immunocytochemistry results were included. Demographic, molecular, immunophenotyping and MIB-1 PI data were collected from cytologic reports. Cases were subtyped according to the current World Health Organization classification and separated into indolent, aggressive, and highly aggressive groups. Statistical analysis was performed with pairwise Wilcoxon rank sum test and linear discriminant analysis to suggest appropriate PI cutpoints.
Ninety-one NHL cases were subdivided in 56 (61.5%) indolent, 30 (33%) aggressive, and 5 (5.5%) highly aggressive lymphomas. The 3 groups had significantly different MIB-1 PIs from each other. Cutpoints were established for separating indolent (<38%), aggressive (> or =38% to < or =80.1%) and highly aggressive (>80.1%). The groups were adequately predicted in 76 cases (83.5%) using the cutpoints and 15 cases showed discrepant PIs.
MIB-1 immunohistochemistry on CS can help to stratify B-cell NHL and showed a significant increase in PI with tumor aggressiveness. Six misclassified cases had PIs close to the cutpoints. Discrepant MIB-1 PIs were related to dilution of positive cells by non-neoplastic lymphocytes and to the overlapping continuum of features between diffuse large B-cell lymphoma and Burkitt lymphoma. Validation of our approach in an unrelated, prospective dataset is required.
MIB-1 增殖指数 (PI) 已被证明有助于非霍奇金淋巴瘤 (NHL) 的诊断和预后。然而，在细针抽吸 (FNA) 样本中使用的经过验证的截止值尚不可用。我们研究了 MIB-1 免疫细胞化学作为 NHL 分层的辅助技术，并试图在细胞学样本中建立 PI 截止值。
纳入具有可用细胞涂片 (CS) MIB-1 免疫细胞化学结果的 B 细胞 NHL FNA 病例。从细胞学报告中收集人口统计学、分子、免疫表型和 MIB-1 PI 数据。根据现行的世界卫生组织分类对病例进行亚型分类，并分为惰性、侵袭性和高度侵袭性组。使用两两 Wilcoxon 秩和检验和线性判别分析进行统计分析，以提出适当的 PI 截止值。
91 例 NHL 病例分为 56 例（61.5%）惰性、30 例（33%）侵袭性和 5 例（5.5%）高度侵袭性淋巴瘤。这 3 组之间的 MIB-1 PI 存在显著差异。建立了用于区分惰性 (<38%)、侵袭性 (> =38%至 < =80.1%) 和高度侵袭性 (>80.1%) 的截止值。使用这些截止值可在 76 例（83.5%）病例中对组进行充分预测，而 15 例病例显示 PI 存在差异。
CS 上的 MIB-1 免疫组化有助于对 B 细胞 NHL 进行分层，并显示 PI 随着肿瘤侵袭性的增加而显著增加。6 例分类错误的病例 PI 接近截止值。PI 存在差异与非肿瘤性淋巴细胞对阳性细胞的稀释以及弥漫性大 B 细胞淋巴瘤和伯基特淋巴瘤之间特征的重叠连续性有关。需要在一个独立的、前瞻性数据集验证我们的方法。
