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

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.

[Color Doppler ultrasound evaluation of a Chinese herbal formula in treating lower limb arteriosclerosis: a randomized controlled trial].

OBJECTIVE: To observe the effects of a Chinese compound herbal medicine for reinforcing qi, activating blood circulation, expelling phlegm and dredging collaterals in treatment of lower limb arteriosclerosis. METHODS: The outpatients and inpatients with lower limb arteriosclerosis from Shanghai Yueyang Hospital of Integrated Traditional Chinese and Western Medicine were randomly divided into control group and treatment group after color Doppler ultrasound inspection, and there were 30 cases in each group. The patients in the treatment group were treated with simvastatin and a Chinese compound herbal medicine for reinforcing qi, activating blood circulation, expelling phlegm and dredging collaterals, and the patients in the control group were treated only with simvastatin. The color Doppler ultrasound imaging of lower limb arteries including inside diameter, intima-media thickness, and plaque area in all the patients were examined after 6-month treatment. The levels of serum total cholesterol (TC) and low-density lipoprotein (LDL) were detected too. RESULTS: After the treatment, the lower limb artery intima-media thickness and artery plaque area in the treatment group decreased obviously as compared with those in the control group (P < 0.05). Color Doppler flow imaging showed that the percentage of patients with uniphase wave decreased from 26.67% (8/30) to 6.67% (2/30) in the treatment group (P < 0.05), and from 26.67% (8/30) to 16.67% (5/30) in the control group (P < 0.05) as compared with those before the treatment, and there was also a significant difference between the two groups (P < 0.05). The concentrations of serum TC and LDL in the treatment group were lower than those in the control group (P < 0.05). CONCLUSION: Color Doppler ultrasound showed that the Chinese compound medicine for reinforcing qi, activating blood circulation, expelling phlegm and dredging collaterals has positive effects on lower limb arteriosclerosis.