Publication
Ki-67 as a prognostic marker in mantle cell lymphoma-consensus guidelines of the pathology panel of the European MCL Network
Journal Paper/Review - Jun 16, 2009
Klapper Wolfram, Möller Peter, Barth Thomas, Muller-Hermelink Konrad, Rosenwald Andreas, Ott German, Pileri Stefano, Ralfkiaer Elisabeth, Rymkiewicz Grzegorz, van Krieken Johan, Wacker Hans, Unterhalt Michael, Hiddemann Wolfgang, Dreyling Martin, Stein Harald, Loddenkemper Christoph, Hoster Eva, Determann Olaf, Oschlies Ilske, van der Laak Jeroen, Berger Françoise, Bernd Heinz, Cabeçadas José, Campo Elias, Cogliatti Sergio B., Hansmann Martin, Kluin Philip, Kodet Roman, Krivolapov Yuri, for the European MCL Network
Units
PubMed
Doi
Citation
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Journal
Publication Date
Issn Print
Brief description/objective
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 x 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 x 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.