Elsharawi Ibrahim, Selegean Sorin, Carter Michael
Department of Pathology and Laboratory Medicine, Division of Anatomical Pathology and Hematological Pathology, Dalhousie University, Halifax, NS, Canada.
Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia B3H 2Y9, Canada.
J Hematol. 2024 Oct;13(5):200-206. doi: 10.14740/jh1333. Epub 2024 Oct 11.
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.
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.
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.
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.
套细胞淋巴瘤（MCL）中的失活突变与预后不良相关。虽然下一代测序（NGS）是评估p53状态的金标准，但p53免疫组织化学（IHC）是评估p53状态的另一种方法，在MCL中尚未得到充分表征。在这项单中心三级医疗中心实验室研究中，我们旨在评估p53 IHC与MCL病例中p53状态的一致性，以期评估前者是否可作为对这些患者进行风险分层的准确、及时且具有成本效益的方法。
本研究纳入了47例行NGS检测的MCL病例。主要目的是将NGS结果与p53 IHC结果进行关联。次要目的包括评估p53状态与其他变量（人口统计学、独特的组织病理学和IHC特征）之间可能存在的关联。同时还比较了NGS和p53 IHC的周转时间和成本。
47例（28%）病例经NGS检测发现存在p53突变。p53 IHC与NGS显示出良好的一致性，具有中度至高度敏感性（11/13，85%）和出色的特异性（34/34，100%）。次要目的显示，p53突变病例中SOX11阴性状态增加（3/13，23%对1/29，3%，P = 0.045）。NGS的成本和周转时间分别约为p53 IHC的30倍和6倍。
p53 IHC在MCL中与NGS显示出良好的一致性，对识别失活的p53突变具有高特异性和中度敏感性。基于我们的研究结果，p53 IHC可能是MCL风险分层中一种高效且具有成本效益的工具。
