Ahmad Alkhasawneh 1 , John D Reith 1 , Tania Zuluaga Toro 1 , Ayed O Ayed 2 , Xiaomin Lu 3 , Thomas J George 2 , Lizette Vila Duckworth 4 Show Affiliations »
Abstract
OBJECTIVES: Accurate grading of gastrointestinal stromal tumors (GISTs), based on mitotic index, can be problematic. METHODS: In this study, we compared interobserver variability in detecting mitosis on H&E with PHH3 immunohistochemistry (IHC). In addition, we examined the correlation between H&E mitosis and Ki-67 and the association of PHH3 and Ki-67 with overall survival. Four pathologists independently reviewed 50 GIST cases. RESULTS: Intraclass correlation coefficients showed good interobserver variability for mitotic counts on both H&E (0.918; 95% confidence interval [CI], 0.874-0.950) and PHH3 IHC (0.923; 95% CI, 0.882-0.953). Nineteen (38%) cases were graded higher and five (10%) cases were downgraded by at least one observer using PHH3 compared with H&E. Using receiver operating characteristic curve analysis, a PHH3 cutoff of seven or more mitoses was associated with worse overall survival (P = .028). Ki-67 showed poor correlation with H&E mitotic counts and overall survival (P = .077). CONCLUSIONS: PHH3 may thus be a valuable adjunct for risk stratification in GISTs. Copyright© by the American Society for Clinical Pathology.
OBJECTIVES: Accurate grading of gastrointestinal stromal tumors (GISTs), based on mitotic index, can be problematic. METHODS: In this study, we compared interobserver variability in detecting mitosis on H&E with PHH3 immunohistochemistry (IHC). In addition, we examined the correlation between H&E mitosis and Ki-67 and the association of PHH3 and Ki-67 with overall survival. Four pathologists independently reviewed 50 GIST cases. RESULTS: Intraclass correlation coefficients showed good interobserver variability for mitotic counts on both H&E (0.918; 95% confidence interval [CI], 0.874-0.950) and PHH3 IHC (0.923; 95% CI, 0.882-0.953). Nineteen (38%) cases were graded higher and five (10%) cases were downgraded by at least one observer using PHH3 compared with H&E. Using receiver operating characteristic curve analysis, a PHH3 cutoff of seven or more mitoses was associated with worse overall survival (P = .028). Ki-67 showed poor correlation with H&E mitotic counts and overall survival (P = .077). CONCLUSIONS: PHH3 may thus be a valuable adjunct for risk stratification in GISTs. Copyright© by the American Society for Clinical Pathology.
Entities: Chemical
Disease
Keywords:
Anti–phosphohistone H3; Gastrointestinal stromal tumors; Ki-67; Mitoses; Soft tissue
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Year: 2015
PMID： 25696796 DOI： 10.1309/AJCPAPH28VHZEKNQ
Source DB: PubMed Journal: Am J Clin Pathol ISSN： 0002-9173 Impact factor: 2.493