Histopathology · 2012
Does the proliferation fraction help identify mature B cell lymphomas with double- and triple-hit translocations?
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Mationg-Kalaw Emarene, Tan Leonard H C, Tay Kevin, Lim Soon Thye, Tang Tiffany, Lee Yvonne Y L, Tan Soo Yong
Аннотация
AIMS: The entity 'B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma (BL)' refers to B cell neoplasms that share overlapping characteristics of BL and DLBCL. A subset of these 'grey-zone lymphomas' possesses C-MYC and IGH translocations but, in addition, contains additional rearrangements of BCL2 and/or BCL6 genes. The aim of this study was to investigate if the proliferation fraction by Ki67 immunostaining can be used to identify such double-/triple-hit lymphomas.
METHODS AND RESULTS: We studied 492 cases of mature aggressive B cell neoplasms by histology, immunohistochemistry and interphase fluorescence in-situ hybridization (FISH) using break-apart probes against C-MYC, BCL2, BCL6, IGH, MALT1, PAX5 and CCND1. Forty Burkitt lymphomas and 28 cases of MYC(+) double-/triple-hit lymphomas were identified. Of the latter, 77% and 54% displayed proliferation fractions exceeding 75% and 90%, respectively. With a cut-off of >75% by Ki67 immunostaining, the sensitivity and specificity for detection of MYC(+) double/triple translocations was 0.77 and 0.36. Raising the proliferation fraction criterion to >90% improved the specificity to 0.62 at the expense of a low sensitivity of 0.54.
CONCLUSIONS: Immunostaining for Ki67 is not a useful approach to prescreen B cell lymphomas for MYC(+) double/triple translocations.
METHODS AND RESULTS: We studied 492 cases of mature aggressive B cell neoplasms by histology, immunohistochemistry and interphase fluorescence in-situ hybridization (FISH) using break-apart probes against C-MYC, BCL2, BCL6, IGH, MALT1, PAX5 and CCND1. Forty Burkitt lymphomas and 28 cases of MYC(+) double-/triple-hit lymphomas were identified. Of the latter, 77% and 54% displayed proliferation fractions exceeding 75% and 90%, respectively. With a cut-off of >75% by Ki67 immunostaining, the sensitivity and specificity for detection of MYC(+) double/triple translocations was 0.77 and 0.36. Raising the proliferation fraction criterion to >90% improved the specificity to 0.62 at the expense of a low sensitivity of 0.54.
CONCLUSIONS: Immunostaining for Ki67 is not a useful approach to prescreen B cell lymphomas for MYC(+) double/triple translocations.
Предметные рубрики MeSH
AdultAgedAged, 80 and overBurkitt LymphomaCell ProliferationDiagnosis, DifferentialEarly Detection of CancerFemaleGenetic TestingHumansImmunoglobulin Heavy ChainsKi-67 AntigenLymphoma, B-CellLymphoma, Large B-Cell, DiffuseMaleMiddle AgedProto-Oncogene Proteins c-bcl-2Proto-Oncogene Proteins c-bcl-6Proto-Oncogene Proteins c-mycRetrospective StudiesSensitivity and SpecificityTranslocation, Genetic