title: MYC Immunohistochemistry to Identify MYC-Driven B-Cell Lymphomas in Clinical Practice.
abstract: OBJECTIVE
  Immunohistochemistry with anti-MYC antibody (MYC IHC) detects MYC protein in fixed samples of aggressive B-cell lymphomas and, according to the number of positive staining tumor nuclei, facilitates tumor subclassification, predicts underlying MYC rearrangements, and stratifies patient outcome. We aimed to determine the performance of MYC IHC in clinical practice.
  
  
  METHODS
  We reviewed MYC IHC performed on control specimens and 256 aggressive B-cell lymphomas and compared clinically reported IHC scores with experts' review.
  
  
  RESULTS
  Control tissues showed less than 5% variation in daily IHC staining. Reported and expert IHC scores were well correlated (r = 0.86) with an SD of 14.2%. Reported IHC scores 30% or less and 70% or more were accurate (94.5%) compared with experts in categorizing tumors as "MYC IHC-Low" and "MYC IHC-High," respectively, but scores 40% to 60% were not (60.3%). The mean IHC score among lymphomas with MYC rearrangements was 80%, but with a large range of scores (20%-100%). There was no statistically significant association between IHC score and MYC copy number.
  
  
  CONCLUSIONS
  Under optimal conditions, clinically reported MYC IHC scores are concordant with expert scores within 15%. MYC IHC does not capture all B-cell lymphomas with MYC rearrangements, however. MYC IHC and MYC fluorescence in situ hybridization are both recommended to identify MYC-driven B-cell lymphomas.
authors.affiliation: From the Department of Pathology, Brigham and Women's Hospital, Boston, MA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kluk
authors.affiliation: From the Department of Pathology, Brigham and Women's Hospital, Boston, MA.
authors.forename: Caleb
authors.initials: C
authors.lastname: Ho
authors.affiliation: Department of Pathology, UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester.
authors.forename: Hongbo
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Pathology, UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Chen
authors.affiliation: Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA.
authors.forename: Donna S
authors.initials: DS
authors.lastname: Neuberg
authors.affiliation: From the Department of Pathology, Brigham and Women's Hospital, Boston, MA.
authors.forename: Paola
authors.initials: P
authors.lastname: Dal Cin
authors.affiliation: Department of Pathology, UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Woda
authors.affiliation: From the Department of Pathology, Brigham and Women's Hospital, Boston, MA.
authors.forename: Geraldine S
authors.initials: GS
authors.lastname: Pinkus
authors.affiliation: From the Department of Pathology, Brigham and Women's Hospital, Boston, MA srodig@partners.org.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Rodig
mesh_terms: D001706:Biopsy; D002051:Burkitt Lymphoma / Q000175:diagnosis* / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D017404:In Situ Hybridization, Fluorescence / Q000379:methods*; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000378:metabolism; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000378:metabolism; D008404:Massachusetts; D015588:Observer Variation; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics* / Q000378:metabolism; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014178:Translocation, Genetic
chemical_list: C489427:MYC protein, human; D016271:Proto-Oncogene Proteins c-myc
keywords: B-cell lymphoma; Burkitt lymphoma; Diffuse large B-cell lymphoma; Fluorescence in situ hybridization; Immunohistochemistry; MYC