Utility of Proliferation Markers Ki-67 and PHH3 in Predicting Malignancy in Basaloid Salivary Gland Neoplasms: A Study Using Digital Image Analysis of Cytology Cell Blocks

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Diagnostic Cytopathology Pub Date : 2025-02-25 DOI:10.1002/dc.25453

Yanki Yarman, Robert Post, Zachary Breslin, Charalambos C. Solomides, Stacey M. Gargano

{"title":"Utility of Proliferation Markers Ki-67 and PHH3 in Predicting Malignancy in Basaloid Salivary Gland Neoplasms: A Study Using Digital Image Analysis of Cytology Cell Blocks","authors":"Yanki Yarman, Robert Post, Zachary Breslin, Charalambos C. Solomides, Stacey M. Gargano","doi":"10.1002/dc.25453","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Basaloid salivary gland neoplasms (BSNs) are notoriously difficult to classify in fine needle aspiration (FNA) specimens due to the morphologic overlap of benign and malignant entities. Adenoid cystic carcinoma (AdCC) represents a particular diagnostic challenge, as it typically shows low-grade cytologic features despite its aggressive clinical behavior. We examined whether the proliferation markers Ki-67 and PHH3 could help predict malignancy in BSNs.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A retrospective search was conducted to identify FNA cases of BSNs that had adequate tumor cellularity in the cell block and a subsequent excision specimen. Ki-67 and PHH3 immunohistochemical stains were performed. Aperio (Leica Biosystems) was used to calculate the percentage of tumor cell nuclear expression. Proliferation scores and final histopathologic diagnoses were correlated using a two-sided <i>p</i>-value test.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Ten benign and 14 malignant basaloid neoplasms were analyzed. Benign cases showed low mean percentages of tumor cell staining for Ki-67 (1.14%) and PHH3 (0.84%), while malignant cases showed significantly higher mean percentages, especially with Ki-67 (19% for low-grade malignancies and 25.5% for high-grade malignancies). The difference in proliferation marker scores between the benign and low-grade malignant cases showed statistical significance for both Ki-67 (<i>p</i> = 0.0041) and PHH3 (<i>p</i> = 0.00397). The difference between benign entities and AdCC was also statistically significant for Ki-67 (<i>p</i> = 0.0013) and PHH3 (<i>p</i> = 0.002).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Ki-67 and PHH3 analysis in cell block material may help predict malignancy in a cytologic specimen from a BSN, offering a valuable ancillary tool for cases with cytomorphologic ambiguity. In particular, the ability to suggest a sample is more likely to be AdCC rather than another morphologically similar low-grade BSN would be helpful for surgical planning.</p>\n </section>\n </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"238-245"},"PeriodicalIF":1.0000,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dc.25453","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic Cytopathology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/dc.25453","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Basaloid salivary gland neoplasms (BSNs) are notoriously difficult to classify in fine needle aspiration (FNA) specimens due to the morphologic overlap of benign and malignant entities. Adenoid cystic carcinoma (AdCC) represents a particular diagnostic challenge, as it typically shows low-grade cytologic features despite its aggressive clinical behavior. We examined whether the proliferation markers Ki-67 and PHH3 could help predict malignancy in BSNs.

Methods

A retrospective search was conducted to identify FNA cases of BSNs that had adequate tumor cellularity in the cell block and a subsequent excision specimen. Ki-67 and PHH3 immunohistochemical stains were performed. Aperio (Leica Biosystems) was used to calculate the percentage of tumor cell nuclear expression. Proliferation scores and final histopathologic diagnoses were correlated using a two-sided p-value test.

Results

Ten benign and 14 malignant basaloid neoplasms were analyzed. Benign cases showed low mean percentages of tumor cell staining for Ki-67 (1.14%) and PHH3 (0.84%), while malignant cases showed significantly higher mean percentages, especially with Ki-67 (19% for low-grade malignancies and 25.5% for high-grade malignancies). The difference in proliferation marker scores between the benign and low-grade malignant cases showed statistical significance for both Ki-67 (p = 0.0041) and PHH3 (p = 0.00397). The difference between benign entities and AdCC was also statistically significant for Ki-67 (p = 0.0013) and PHH3 (p = 0.002).

Conclusion

Ki-67 and PHH3 analysis in cell block material may help predict malignancy in a cytologic specimen from a BSN, offering a valuable ancillary tool for cases with cytomorphologic ambiguity. In particular, the ability to suggest a sample is more likely to be AdCC rather than another morphologically similar low-grade BSN would be helpful for surgical planning.

Abstract Image

查看原文本刊更多论文

增殖标志物Ki-67和PHH3在预测基底样唾液腺肿瘤恶性中的应用：细胞学细胞块数字图像分析的研究。

导言：在细针抽吸（FNA）标本中，基底样唾液腺肿瘤（BSNs）是出了名的难以分类，因为其良性和恶性实体的形态学重叠。腺样囊性癌（AdCC）代表了一种特殊的诊断挑战，因为尽管其具有侵袭性的临床行为，但它通常表现出低级别的细胞学特征。我们检测了增殖标志物Ki-67和PHH3是否可以帮助预测bsn的恶性。方法：进行回顾性搜索，以确定在细胞块和随后的切除标本中具有足够肿瘤细胞度的BSNs的FNA病例。Ki-67和PHH3免疫组化染色。利用Aperio （Leica Biosystems）软件计算肿瘤细胞核表达率。使用双侧p值检验将增殖评分和最终组织病理学诊断相关联。结果：分析了10例良性基底细胞瘤，14例恶性基底细胞瘤。良性病例Ki-67和PHH3的平均染色率较低，分别为1.14%和0.84%，而恶性病例Ki-67的平均染色率明显较高（低级别恶性肿瘤为19%，高级别恶性肿瘤为25.5%）。增殖标志物Ki-67评分（p = 0.0041）、PHH3评分（p = 0.00397）在良、低度恶性病例间差异均有统计学意义。良性实体与AdCC之间Ki-67 （p = 0.0013）和PHH3 （p = 0.002）的差异也有统计学意义。结论：细胞块材料中Ki-67和PHH3的分析可能有助于预测BSN细胞学标本的恶性肿瘤，为细胞形态学不明确的病例提供了有价值的辅助工具。特别是，提示样本更有可能是AdCC而不是其他形态相似的低级别BSN的能力将有助于手术计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Diagnostic Cytopathology 医学-病理学

CiteScore

2.60

自引率

7.70%

发文量

163

审稿时长

3-6 weeks

期刊介绍： Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.