Department of Pathology, West China Hospital of Sichuan University, Chengdu, China.
Ann Hematol. 2022 Oct;101(10):2271-2279. doi: 10.1007/s00277-022-04922-8. Epub 2022 Aug 3.
P53 prognostic cut-off values differ between studies of mantle cell lymphoma (MCL), and its immunohistochemistry (IHC) interpretation is still based on semiquantitative estimation, which might be inaccurate. This study aimed to investigate the optimal cut-off value for p53 in predicting prognosis of patients with MCL and the possible use of computer image analysis to identify the positive rate of p53. We calculated p53 positive rate using QuPath software and compared it with the data obtained by manual counting and semiquantitative estimation. Survival curves were generated by using the Youden index and the Kaplan-Meier method. The chi-squared (χ2) test was used to compare MIPI, Ann Arbor stage, and cell morphology with p53. Spearman rank correlation test and Bland-Altman analysis were used to compare manual counting, computer image analysis and semiquantitative estimation, as well as the consistency between different observers. The optimal cut-off value of p53 for predicting prognosis was 20% in MCL patients. Patients with p53 ≥ 20% had a significantly worse overall survival (OS) than those with p53 < 20% (P < 0.0001). MCL patients with MIPI intermediate to high risk, Ann Arbor stage III-IV, and blastoid/pleomorphic variant cell morphology had more p53 ≥ 20%. There was a strong correlation between computer image analysis and manual counting of p53 from the same areas in MCL tissues (Spearman's rho = 0.966, P < 0.0001). The results of computer analysis are completely consistent between observers, and computer image analysis of Ki-67 can predict the prognosis of MCL patients. MCL patients with p53 ≥ 20% had a shorter OS and a tendency for MIPI intermediate to high risk, Ann Arbor stage III-IV, and blastoid/pleomorphic variant. Computer image analysis could determine the actual positive rate of p53 and Ki-67 and is a more attractive alternative than semiquantitative estimation in MCL.
p53 预后截断值在套细胞淋巴瘤（MCL）的研究中存在差异，其免疫组化（IHC）解释仍基于半定量评估，可能不够准确。本研究旨在探讨 p53 预测 MCL 患者预后的最佳截断值，以及计算机图像分析在识别 p53 阳性率方面的可能应用。我们使用 QuPath 软件计算 p53 阳性率，并将其与手动计数和半定量评估获得的数据进行比较。使用 Youden 指数和 Kaplan-Meier 法生成生存曲线。使用卡方（χ2）检验比较 MIPI、Ann Arbor 分期和细胞形态与 p53 的关系。Spearman 秩相关检验和 Bland-Altman 分析用于比较手动计数、计算机图像分析和半定量评估，以及不同观察者之间的一致性。在 MCL 患者中，p53 预测预后的最佳截断值为 20%。p53≥20%的患者总生存期（OS）明显差于 p53<20%的患者（P<0.0001）。MIPI 中高危、Ann Arbor 分期 III-IV 和母细胞样/多形性变异的 MCL 患者中 p53≥20%的比例更高。MCL 组织中同一区域的 p53 手动计数与计算机图像分析之间存在很强的相关性（Spearman 相关系数=0.966，P<0.0001）。观察者之间的计算机分析结果完全一致，Ki-67 的计算机图像分析可预测 MCL 患者的预后。p53≥20%的 MCL 患者 OS 更短，MIPI 中高危、Ann Arbor 分期 III-IV 和母细胞样/多形性变异的趋势更明显。计算机图像分析可以确定 p53 和 Ki-67 的实际阳性率，与 MCL 中的半定量评估相比，是一种更有吸引力的替代方法。
