The prognostic value of Ki-67 antigen in non-Hodgkin lymphoma of Waldeyer ring and the nasal cavity.
BACKGROUND
A monoclonal antibody, Ki-67, recognizes an antigen expressed in all phases of the cell cycle, except G0, and can be used as a simple histologic marker of cell proliferation. To assess the prognostic value of the growth fraction in non-Hodgkin lymphoma of Waldeyer ring (W-NHL) and the nasal cavity (N-NHL), the authors applied Ki-67 immunostaining combined with image analysis on such lymphomas.


METHODS
The authors studied 29 patients (18 with W-NHL and 11 with N-NHL), applying Ki-67 to frozen sections. The number of Ki-67-positive cells in a unit area (0.044 mm2), as an indicator of proliferative activity, and the mean area per Ki-67-positive cell (microns2), as an indicator of DNA content, were measured by the image processing system.


RESULTS
High-grade lymphomas showed a significantly larger number of Ki-67-positive cells than intermediate-grade lymphomas (102.5 +/- 21.6 in high-grade and 46.8 +/- 8.92 in intermediate-grade lymphomas, P = 0.03), even when analyzed separately by immunophenotypes. A large mean area per Ki-67-positive cell was associated significantly with a T-cell phenotype (36.3 +/- 7.69 microns2 in T-cell lymphomas and 19.4 +/- 2.33 microns2 in B-cell lymphomas, P = 0.034) and an unfavorable clinical outcome. High proliferative activity, defined as nuclear Ki-67 expression in 2000 or more B-cell lymphoma cells and 1000 or more T-cell lymphoma cells in a 1-mm2 area, was found to be a strong predictor of poor survival among these patients (P = 0.048 and P = 0.009, respectively).


CONCLUSIONS
Ki-67 immunostaining, combined with image analysis, is a novel method for determining a tumor proliferative index that provides useful clinical data regarding head and neck lymphomas.
Yamanaka
N
N
Department of Otolaryngology, Sapporo Medical College, Japan.
Harabuchi
Y
Y
Kataura
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002466:Cell Nucleolus / Q000648:ultrastructure; D002467:Cell Nucleus / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016130:Immunophenotyping; D019394:Ki-67 Antigen; D016393:Lymphoma, B-Cell / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology; D016400:Lymphoma, Large-Cell, Immunoblastic / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology* / Q000503:physiopathology; D016399:Lymphoma, T-Cell / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology*; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000473:pathology* / Q000503:physiopathology; D009687:Nuclear Proteins / Q000032:analysis*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000473:pathology; D015996:Survival Rate; D013601:T-Lymphocytes / Q000473:pathology*; D014067:Tonsillar Neoplasms / Q000473:pathology* / Q000503:physiopathology
D019394:Ki-67 Antigen; D009687:Nuclear Proteins