Combined utility of CD177, P53, CD105 and c-kit immunohistochemical stains improves the detection of myelodysplastic syndrome

Ann Diagn Pathol. 2021 Dec:55:151810. doi: 10.1016/j.anndiagpath.2021.151810. Epub 2021 Aug 27.

Abstract

The diagnosis of myelodysplastic syndrome (MDS) relies primarily on identifying peripheral blood cytopenia and morphologic dysplasia as well as detecting cytogenetic aberrations in a subset of patients. Accumulating data points to the importance of examining certain immunophenotypic changes characteristic of MDS, most of which are tested by flow cytometry. The role of immunohistochemistry in the diagnostic workup of MDS is less known. In this study, we used immunohistochemistry to survey the expression patterns of CD177, P53, CD105 and c- kit in a cohort of MDS bone marrow specimens (n = 57) and compared the results with a control group of patients who had cytopenia for other benign conditions (n = 49). MDS cases showed significant higher rates of: CD177-loss (13/57, 23% vs 1/49, 2%; P = .0016), P53 overexpression (8/57, 14% vs none; P = .005) and the presence of clusters of CD105-positive cells (6/57, 11% vs none; P = .021). Increased c-kit-positive cells was more common in MDS patients, but not statistically significant (17/57, 30% vs 8/49, 16%; P = .102). On multivariate analysis, only loss of CD177 expression was significantly higher in MDS group (P = .014). These findings suggest that a panel of immunohistochemical stains could serve as an adjunct tool in investigating unexplained cytopenias and warrant further comparative studies with flow cytometry.

Keywords: Bone marrow; CD105; CD117; CD177; Cytopenia; Immunohistochemistry; Myelodysplastic syndrome; P53; c-Kit.

MeSH terms

  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / metabolism
  • Bone Marrow / metabolism
  • Bone Marrow / pathology
  • Chromosome Aberrations
  • Cohort Studies
  • Cytodiagnosis
  • Endoglin / analysis
  • Endoglin / metabolism
  • GPI-Linked Proteins / analysis
  • GPI-Linked Proteins / metabolism
  • Immunohistochemistry*
  • Immunophenotyping
  • Isoantigens / analysis
  • Isoantigens / metabolism
  • Myelodysplastic Syndromes* / diagnosis
  • Myelodysplastic Syndromes* / metabolism
  • Proto-Oncogene Proteins c-kit / analysis
  • Proto-Oncogene Proteins c-kit / metabolism
  • Receptors, Cell Surface / analysis
  • Receptors, Cell Surface / metabolism
  • Thrombocytopenia / metabolism
  • Tumor Suppressor Protein p53 / analysis
  • Tumor Suppressor Protein p53 / metabolism

Substances

  • Biomarkers, Tumor
  • CD177 protein, human
  • Endoglin
  • GPI-Linked Proteins
  • Isoantigens
  • Receptors, Cell Surface
  • Tumor Suppressor Protein p53
  • Proto-Oncogene Proteins c-kit