Abstract
Non-hodgkin lymphoma (NHL) is a diverse group of disease encompassing divergent tumor types with contrasting clinical behaviors. We aimed to evaluate the usefulness of Ki67 index in segregating indolent from aggressive NHL and its association with clinical parameters. During a study period of 4.5 years, a total of 215 cases of lymphomas were diagnosed among of which 172 cases were NHL. Ki67 immunohistochemical staining was performed by the DAKO envision method. Average proportion of tumor cells stained was calculated to determine the proliferative index. The mean age at diagnosis was 46.2 years +19.8 (3-81) with a male to female ratio of 1.5:1. Mean Ki67 index for indolent NHL included 23% for small cell, 25% for mantle cell, 28.5% for marginal zone and 34.6% for follicular lymphoma. On the other hand, mean Ki67 index for aggressive lymphomas were 66.4%, 66.9%, 80.3%, 83.3% and 94.4% for diffuse large B cell, T cell (NOS), anaplastic large cell, lymphoblastic and burkitts lymphoma respectively. No significant correlation was found between Ki67 index and other clinical parameters like age and extra nodal involvement. Ki67 index is a valuable IHC marker to distinguish indolent from aggressive lymphomas especially in small needle biopsies where exact typing may not be possible.
Highlights
Traditional grading parameters like nuclear pleomorphism and mitotic count doesn’t apply to lymphoid neoplasms where classification is mainly based on cell size and morphology
We aimed to evaluate the usefulness of Ki67 index in segregating indolent from aggressive Non-hodgkin lymphoma (NHL) and its association with clinical parameters
The Ki67 antigen was first described by Gerdes & colleagues in the early 1980s, by use of a mouse monoclonal antibody against a nuclear antigen from a Hodgkins lymphoma (HL) derived cell line (Gerdes et al, 1983)
Summary
Traditional grading parameters like nuclear pleomorphism and mitotic count doesn’t apply to lymphoid neoplasms where classification is mainly based on cell size and morphology. Estimation of proliferative index as a marker of tumor aggressiveness has long been known. Immunohistochemical expression of Ki67 antigen in paraffin section called Ki67 proliferative index, represents the active growth fraction of the tumor. Non-hodgkin lymphoma (NHL) is a diverse group of disease encompassing divergent tumor types with contrasting clinical behaviors. We aimed to evaluate the usefulness of Ki67 index in segregating indolent from aggressive NHL and its association with clinical parameters. Average proportion of tumor cells stained was calculated to determine the proliferative index. Mean Ki67 index for indolent NHL included 23% for small cell, 25% for mantle cell, 28.5% for marginal zone and 34.6% for follicular lymphoma. Conclusions: Ki67 index is a valuable IHC marker to distinguish indolent from aggressive lymphomas especially in small needle biopsies where exact typing may not be possible
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