Ki-67 as a prognostic marker in mantle cell lymphoma-consensus guidelines of the pathology panel of the European MCL Network.
Mantle cell lymphoma (MCL) has a heterogeneous clinical course and is mainly an aggressive B cell non-Hodgkin lymphoma; however, there are some indolent cases The Ki-67 index, defined by the percentage of Ki-67-positive lymphoma cells on histopathological slides, has been shown to be a very powerful prognostic biomarker. The pathology panel of the European MCL Network evaluated methods to assess the Ki-67 index including stringent counting, digital image analysis, and estimation by eyeballing. Counting of 2 × 500 lymphoma cells is the gold standard to assess the Ki-67 index since this value has been shown to predict survival in prospective randomized trials of the European MCL Network. Estimation by eyeballing and digital image analysis showed a poor concordance with the gold standard (concordance correlation coefficients [CCC] between 0.29 and 0.61 for eyeballing and CCC of 0.24 and 0.37 for two methods of digital image analysis, respectively). Counting a reduced number of lymphoma cells (2 × 100 cells) showed high interobserver agreement (CCC = 0.74). Pitfalls of the Ki-67 index are discussed and guidelines and recommendations for assessing the Ki-67 index in MCL are given.
Klapper
Wolfram
W
Hoster
Eva
E
Determann
Olaf
O
Oschlies
Ilske
I
van der Laak
Jeroen
J
Berger
Françoise
F
Bernd
Heinz Wolfram
HW
Cabeçadas
José
J
Campo
Elias
E
Cogliatti
Sergio
S
Hansmann
Martin Leo
ML
Kluin
Philip M
PM
Kodet
Roman
R
Krivolapov
Yuri A
YA
Loddenkemper
Christoph
C
Stein
Harald
H
Möller
Peter
P
Barth
Thomas E F
TE
Müller-Hermelink
Konrad
K
Rosenwald
Andreas
A
Ott
German
G
Pileri
Stefano
S
Ralfkiaer
Elisabeth
E
Rymkiewicz
Grzegorz
G
van Krieken
Johan H
JH
Wacker
Hans Heinrich
HH
Unterhalt
Michael
M
Hiddemann
Wolfgang
W
Dreyling
Martin
M