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Prognostic value and computer image analysis of p53 in mantle cell lymphoma

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Abstract

P53 prognostic cut-off values differ between studies of mantle cell lymphoma (MCL), and its immunohistochemistry (IHC) interpretation is still based on semiquantitative estimation, which might be inaccurate. This study aimed to investigate the optimal cut-off value for p53 in predicting prognosis of patients with MCL and the possible use of computer image analysis to identify the positive rate of p53. We calculated p53 positive rate using QuPath software and compared it with the data obtained by manual counting and semiquantitative estimation. Survival curves were generated by using the Youden index and the Kaplan–Meier method. The chi-squared (χ2) test was used to compare MIPI, Ann Arbor stage, and cell morphology with p53. Spearman rank correlation test and Bland–Altman analysis were used to compare manual counting, computer image analysis and semiquantitative estimation, as well as the consistency between different observers. The optimal cut-off value of p53 for predicting prognosis was 20% in MCL patients. Patients with p53 ≥ 20% had a significantly worse overall survival (OS) than those with p53 < 20% (P < 0.0001). MCL patients with MIPI intermediate to high risk, Ann Arbor stage III–IV, and blastoid/pleomorphic variant cell morphology had more p53 ≥ 20%. There was a strong correlation between computer image analysis and manual counting of p53 from the same areas in MCL tissues (Spearman’s rho = 0.966, P < 0.0001). The results of computer analysis are completely consistent between observers, and computer image analysis of Ki-67 can predict the prognosis of MCL patients. MCL patients with p53 ≥ 20% had a shorter OS and a tendency for MIPI intermediate to high risk, Ann Arbor stage III–IV, and blastoid/pleomorphic variant. Computer image analysis could determine the actual positive rate of p53 and Ki-67 and is a more attractive alternative than semiquantitative estimation in MCL.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

MCL:

Mantle cell lymphoma

OS:

Overall survival

χ2:

Chi-squared

NHL:

Non-Hodgkin lymphoma

MIPI:

Mantle cell lymphoma prognostic index

IHC:

Immunohistochemistry

WHO:

World Health Organization

EDTA:

ethylenediaminetetraacetic acid

DAB:

diaminobenzidine

AUC:

area under the ROC curve

NA:

not applicable

CI:

confidence interval

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Acknowledgements

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Funding

This study was supported by the National Natural Science Foundation of China (81900197) and the Science and Technology Program of Sichuan Province (2020YJ0104).

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    Authors and Affiliations

    1. Department of Pathology, West China Hospital of Sichuan University, Chengdu, China

      Yue-Hua Zhang, Li-Min Gao, Xiao-Yu Xiang, Wen-Yan Zhang & Wei-Ping Liu

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    Contributions

    YHZ, LMG, and WPL contributed to the conceptual design of the study. YHZ and XYX were involved in data acquisition. YHZ, WYZ, and LMG were involved in data analysis and interpretation. YHZ and LMG were involved in writing and editing the manuscript. YHZ, XYX, WYZ, LMG, and WPL reviewed the manuscript. This study was supervised by WPL and LMG.

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    Correspondence to Li-Min Gao or Wei-Ping Liu.

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    The present study was approved by the Institutional Review Board of West China Hospital of Sichuan University (WCH2021-00333). All subjects signed informed consent forms before participating.

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    All subjects signed informed consent forms before participating.

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    The authors declare no competing interests.

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    Yue-Hua Zhang and Li-Min Gao are co-first authors.

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    Zhang, YH., Gao, LM., Xiang, XY. et al. Prognostic value and computer image analysis of p53 in mantle cell lymphoma. Ann Hematol 101, 2271–2279 (2022). https://doi.org/10.1007/s00277-022-04922-8

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