Chong Yosep, Kim Tae Eun, Cho Uiju, Jin Min-Sun, Yim Kwangil, Thakur Nishant, Kim Jong Ok, Cho Inju, Park Gyeongsin
Department of Hospital Pathology, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul 07345, Korea.
Department of Hospital Pathology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu 11765, Korea.
Diagnostics (Basel). 2021 Feb 19;11(2):343. doi: 10.3390/diagnostics11020343.
Diffuse large B-cell lymphoma (DLBCL) is the most common high-grade B-cell lymphoma found in Korea; it manifests with a variety of cellular morphologies and a high proliferation index. It is difficult to differentiate between DLBCL and Burkitt lymphoma (BL) based on immunohistochemistry, histology, and Epstein-Barr virus infection status owing to the overlap in findings. In this study, we performed comparative morphometric analysis to understand the proportional difference in Ki-67 staining between DLBCL and BL. We analyzed Ki-67-stained slides of 103 DLBCLs and 29 BLs that were pathologically confirmed using a three-tier classification system (negative, 1+, 2+, and 3+) to compare Ki-67 expression between BL and activated B-cell and germinal center B-cell subtypes of DLBCL and DLBCL with high proliferation indices (>90% of 2+ and 3+ cells). Patients with DLBCL were older than those with BL (62.1 versus 51.0 years). The number and proportion of negative cells (passenger and true negative cells) were significantly lower in BLs than those in DLBCLs (337.4, 5.9% versus 690.3, 12.4%). The number and proportion of 3+ cells were significantly higher in BLs than those in DLBCLs (5213.6, 96.3% versus 3132.4, 62.0%). BLs and DLBCLs with a high proliferation index showed similar results as those between BLs and overall DLBCLs. We were able to differentiate BLs and DLBCLs with 98.1% sensitivity and 100.0% specificity using an optimal cut-off of 97.9% of 2+/3+ Ki-67-positive cells. Thus, the Ki-67 labeling index may be a good differential biomarker for DLBCLs and BLs.
弥漫性大B细胞淋巴瘤（DLBCL）是韩国最常见的高级别B细胞淋巴瘤；它具有多种细胞形态且增殖指数高。由于结果存在重叠，基于免疫组织化学、组织学和爱泼斯坦-巴尔病毒感染状态，很难区分DLBCL和伯基特淋巴瘤（BL）。在本研究中，我们进行了比较形态计量分析，以了解DLBCL和BL之间Ki-67染色的比例差异。我们分析了103例DLBCL和29例BL的Ki-67染色玻片，这些玻片经病理证实，采用三级分类系统（阴性、1+、2+和3+）来比较BL与DLBCL的活化B细胞和生发中心B细胞亚型以及增殖指数高（2+和3+细胞>90%）的DLBCL之间的Ki-67表达。DLBCL患者比BL患者年龄大（62.1岁对51.0岁）。BL中阴性细胞（过客细胞和真正的阴性细胞）的数量和比例显著低于DLBCL（337.4个，5.9%对690.3个，12.4%）。BL中3+细胞的数量和比例显著高于DLBCL（5213.6个，96.3%对3132.4个，62.0%）。增殖指数高的BL和DLBCL的结果与BL和总体DLBCL之间的结果相似。使用2+/3+ Ki-67阳性细胞的最佳临界值97.9%，我们能够以98.1%的敏感性和100.0%的特异性区分BL和DLBCL。因此，Ki-67标记指数可能是DLBCL和BL的良好鉴别生物标志物。
