Value of DNA image cytometry, and cell proliferation by pCNA index in bone marrow biopsies infiltrated by non-Hodgkin's lymphoma

ABSTRACT

The assessment of DNA ploidy, and proliferative activity by image analysis [IA], was carried out on 17 bone marrow trephine biopsies [BMTBs], from patients with Non-Hodgkin's Lymphoma [NHL]. Comparative estimation of proliferative activity, was performed using immunohistochemical staining of proliferating cell nuclear antigen [PCNA]. In the twelve bone marrow biopsies, infiltrated by NHLs, aneuploidy was detected in 11[91.6%] cases, S Phase Fraction [SPF], ranged from 15.6-32.5, PCNA labeling index, ranged from 4% to 70% with highest score in intermediate grade NHL mixed small and large cell type. A significant correlation was found between SPF and tumor cell burden [TCB], nuclear surface area and nuclear area variance. However no correlation was found between SPF and PCNA index. For bone marrow biopsies, image analysis has advantages over flowcytometry, including better sampling by histologic correlation, the ability to use limited material, and the supplementary information of prognostic indicators, assessed on comparable paraffin blocks. DNA image analysis and PCNA index by immunostaining are complementary methods in assessment of proliferative activity of NHL. However each technique has its advantages and limitations: