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Relevance of Ki-67 expression in the classification of non-Hodgkin's lymphomas: a morphometric and
A Houmand1, B Abrahamsen, N Tinggaard Pedersen
1Department of Pathology, Odense University Hospital, Denmark.
Insights
Corrected Ki-67 counts improve malignancy grading in non-Hodgkin's lymphoma. Adjusting for lymphocytes is crucial for accurate proliferation assessment, enhancing diagnostic reliability.
Area of Science:
- Hematology
- Oncology
- Immunohistochemistry
Background:
- Non-Hodgkin's lymphoma (NHL) diagnosis relies on assessing cell proliferation.
- The monoclonal antibody Ki-67 is a common marker for cell proliferation.
Purpose of the Study:
- To evaluate the utility of Ki-67 morphometry in assessing reactive and neoplastic cell proliferation in NHL.
- To compare Ki-67 findings with histological diagnoses and determine optimal grading strategies.
Main Methods:
- Retrospective analysis of 92 NHL cases using morphometry and double-immunoenzymatic techniques.
- Inclusion of surface markers and Ki-67 monoclonal antibody.
- Comparison of Ki-67 positivity with histological grading and lymphocyte counts.
Main Results:
- Overall Ki-67 positivity requires correction for lymphocyte counts for accurate assessment.
- No significant difference in reactive cell content between follicular and diffuse lymphomas.
- Significantly higher Ki-67 positivity in high-grade lymphomas compared to intermediate-grade.
- 45% corrected Ki-67 counts showed significant agreement with malignancy grade in 76% of cases.
Conclusions:
- Corrected Ki-67 counts are essential for reliable malignancy grading in NHL.
- Macrophage and reactive cell Ki-67 positivity offer limited additional diagnostic value.
- Ki-67 morphometry, when corrected, aids in differentiating lymphoma grades.
Abstract:
The proliferation of reactive and neoplastic cells was retrospectively assessed in 92 cases of non-Hodgkin's lymphoma by morphometry using a double-immunoenzymatic technique including surface markers and the monoclonal antibody Ki-67. The findings were compared with the histological diagnosis. The overall Ki-67 positivity is not always a good measure of the corresponding corrected values and therefore we recommend that a correction should be made for the total number of complementary lymphocytes in the tumour. Taking the macrophages and the Ki-67 positivity of the reactive cells into account does not generally add any information. There was no difference in reactive cell content between follicular (counted within follicles) and diffuse lymphomas within the tumour areas. The value of the group mean for low-grade follicular (nodular) lymphomas was significantly higher than that of diffuse low-grade lymphomas, but not significantly different from that of intermediate-grade lymphomas. High-grade lymphomas exhibited significantly greater Ki-67 positivity than those of intermediate grade. In 76% of the cases there was significant agreement between malignancy grade (low/intermediate malignant versus high malignant) at 45% corrected Ki-67 counts.