Utility of p53 Immunohistochemical Staining for Risk Stratification of Mantle Cell Lymphoma.

BACKGROUND

Inactivating mutations in mantle cell lymphoma (MCL) are associated with poor prognosis. While next-generation sequencing (NGS) is the gold standard for assessing , p53 immunohistochemistry (IHC) is an orthogonal means of evaluating status that has not been well characterized in MCL. In this single tertiary care center laboratory study, we aimed to evaluate the concordance of p53 IHC with the status in cases of MCL in hopes of evaluating if the former could act as an accurate, timely and cost-effective way of risk stratifying these patients.

METHODS

A total of 47 cases of MCL that had NGS performed were included in this study. The main objective was to correlate NGS findings with p53 IHC results. Secondary objectives included assessment of possible associations between status and other variables (demographics, unique histopathological and IHC features). The turn-around time and cost for NGS and p53 IHC were also compared.

RESULTS

Thirteen out of 47 (28%) cases were -mutated by NGS. p53 IHC showed good concordance with NGS, with moderate to high sensitivity (11/13, 85%) and excellent specificity (34/34, 100%). Secondary objectives revealed increased SOX11-negative status in -mutated cases (3/13, 23% vs. 1/29, 3%, P = 0.045). The cost and turn-around time of NGS were approximately of 30- and sixfold those of p53 IHC, respectively.

CONCLUSION

p53 IHC shows good concordance with NGS in MCL, with high specificity and moderate sensitivity for identifying inactivating mutations. Based on our findings, p53 IHC may be an efficient and cost-effective tool in risk stratification of MCL.