Kluk Michael J, Ho Caleb, Yu Hongbo, Chen Benjamin J, Neuberg Donna S, Dal Cin Paola, Woda Bruce A, Pinkus Geraldine S, Rodig Scott J
From the Department of Pathology, Brigham and Women's Hospital, Boston, MA.
Department of Pathology, UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester.
Am J Clin Pathol. 2016 Feb;145(2):166-79. doi: 10.1093/ajcp/aqv028. Epub 2016 Feb 1.
Immunohistochemistry with anti-MYC antibody (MYC IHC) detects MYC protein in fixed samples of aggressive B-cell lymphomas and, according to the number of positive staining tumor nuclei, facilitates tumor subclassification, predicts underlying MYC rearrangements, and stratifies patient outcome. We aimed to determine the performance of MYC IHC in clinical practice.
We reviewed MYC IHC performed on control specimens and 256 aggressive B-cell lymphomas and compared clinically reported IHC scores with experts' review.
Control tissues showed less than 5% variation in daily IHC staining. Reported and expert IHC scores were well correlated (r = 0.86) with an SD of 14.2%. Reported IHC scores 30% or less and 70% or more were accurate (94.5%) compared with experts in categorizing tumors as "MYC IHC-Low" and "MYC IHC-High," respectively, but scores 40% to 60% were not (60.3%). The mean IHC score among lymphomas with MYC rearrangements was 80%, but with a large range of scores (20%-100%). There was no statistically significant association between IHC score and MYC copy number.
Under optimal conditions, clinically reported MYC IHC scores are concordant with expert scores within 15%. MYC IHC does not capture all B-cell lymphomas with MYC rearrangements, however. MYC IHC and MYC fluorescence in situ hybridization are both recommended to identify MYC-driven B-cell lymphomas.
使用抗MYC抗体进行免疫组织化学检测（MYC IHC）可在侵袭性B细胞淋巴瘤的固定样本中检测MYC蛋白，并根据阳性染色肿瘤细胞核的数量促进肿瘤亚分类、预测潜在的MYC重排以及对患者预后进行分层。我们旨在确定MYC IHC在临床实践中的表现。
我们回顾了对对照标本和256例侵袭性B细胞淋巴瘤进行的MYC IHC检测，并将临床报告的IHC评分与专家评审结果进行比较。
对照组织的每日IHC染色差异小于5%。报告的和专家的IHC评分相关性良好（r = 0.86），标准差为14.2%。在将肿瘤分类为“MYC IHC低”和“MYC IHC高”方面，报告的IHC评分分别为30%及以下和70%及以上时与专家的分类准确（94.5%），但40%至60%的评分则不准确（60.3%）。有MYC重排的淋巴瘤的平均IHC评分为80%，但评分范围很大（20%-100%）。IHC评分与MYC拷贝数之间无统计学显著关联。
在最佳条件下，临床报告的MYC IHC评分与专家评分的一致性在15%以内。然而，MYC IHC不能检测到所有具有MYC重排的B细胞淋巴瘤。建议同时使用MYC IHC和MYC荧光原位杂交来识别MYC驱动的B细胞淋巴瘤。
