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. 2024 Jul 23;14(15):1584.
doi: 10.3390/diagnostics14151584.

Assessment of Ki-67 Proliferative Index in Cytological Samples of Nodal B-Cell Lymphomas

Mojca Založnik  1 , Simona Miceska  1   2 , Simon Buček  1   2 , Nataša Nolde  1 , Mojca Gjidera  3 , Ulrika Klopčič  2 , Zorica Čekić  1 , Živa Pohar Marinšek  1 , Gorana Gašljević  3   4 , Veronika Kloboves Prevodnik  1   4
Affiliations

Assessment of Ki-67 Proliferative Index in Cytological Samples of Nodal B-Cell Lymphomas

Mojca Založnik et al. Diagnostics (Basel). .

Abstract

Background: The Ki-67 proliferative index (PI) is part of the diagnosis of nodal B-cell lymphoma (nBCL), but its determination in cytological samples is not standardized. We aimed to establish an approach for the accurate determination of the Ki-67 PI in cytological slides to differentiate between indolent and aggressive nBCLs.

Methods: Patients diagnosed with nBCL by fine-needle aspiration biopsy and subsequent excision biopsy were included. Cell suspensions were prepared from biopsy samples for CD3/Ki-67 double immunocytochemical staining and flow-cytometric verification of lymphoma B-cell counts. The Ki-67 PI was assessed by manual counting and eyeballing in cytology and eyeballing in histology. The cut-off values for the differentiation between aggressive and indolent lymphomas were determined for each method.

Results: A strong correlation between manual and flow-cytometric counting of lymphoma B cells was confirmed (interclass correlation coefficient (IC coef.) = 0.78). The correlation of the Ki-67 PI determined in cytological and histological slides was also strong (IC coef. > 0.80). Histologically, 55 cases were classified as indolent and 31 as aggressive nBCLs. KI-67 PI cut-off values of 28.5%, 27.5%, and 35.5% were established for manual counting and eyeballing in cytology and eyeballing in histology, respectively, with high sensitivity and specificity.

Conclusions: The Ki-67 PI, assessed by manual counting and eyeballing in cytological samples, accurately differentiates between indolent and aggressive nBCLs.

Keywords: Ki-67 proliferative index; eyeballing; fine-needle aspiration biopsy; flow cytometry; immunocytochemistry; immunohistochemistry; lymph node biopsy; manual counting; non-Hodgkin nodal B-cell lymphomas.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Visual description of the study design. Created with Biorender.com.
Figure 2
Figure 2
Dual Ki-67/CD3 immunocytochemical staining on methanol-fixed cytospins of cytological samples. T cells can be identified by unstained nuclei and red-stained cytoplasm for CD3 (as indicated by the red arrow), or by brown-stained nuclei for Ki-67 and red-stained cytoplasm for CD3 (as indicated by the yellow arrow). Lymphoma B cells can be identified as cells with brown-stained nuclei for Ki-67 and unstained cytoplasm (as indicated by the white arrow) (400× magnification).
Figure 3
Figure 3
ROC curves for the differentiation between indolent and aggressive nodal BCHLs using Ki-67 PI for manual counting and eyeballing in cytological samples.
See this image and copyright information in PMC

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