Significance of S-phase Fraction and Nuclear Area in Classification and Prognosis of Non-Hodgkin Lymphoma

Sol, Mee Young; Lee, Sun Kyung; Suh, Kang Suek; Lee, Eun Yup; Kim, Soon Ho

Abstract

BACKGROUND: Non-Hodgkin lymphomas have morphologic and biologic variabilities and are classified by a variety of classification schemes. The authors studied the value of DNA content, S-phase fraction, and nuclear areas as a diagnostic discriminant in classification and predicting the clinical outcome of non-Hodgkin lymphoma.
METHODS
Thirty cases of non-Hodgkin lymphoma and 13 cases of reactive lymph node specimens embedded in paraffin were used. DNA analysis was done by flow cytometric method using propidium iodide staining. Nuclear areas of lymphoma cells were measured by image analyzer. The results of DNA content, S-phase fraction, nuclear areas were statistically analyzed between groups of lymphoma classified according to the Rappaport classification and Working formulation.
RESULTS
Aneuploidy patterns were identified in two cases (6.7%) of non-Hodgkin lymphoma (diffuse poorly differentiated lymphocytic and well differentiated lymphocytic). S-phase fraction and nuclear areas were high in lymphoblastic, diffuse poorly differentiated, diffuse lymphocytic undifferentiated, and diffuse mixed types (unfavorable prognostic group), and which had statistical significance against the low values of diffuse lymphocytic well differentiated type (favorable prognostic group). The S-phase fraction and nuclear area had significant correlation, so they could represent correlation between high proliferative activity and large nuclear area. High, intermediate, and low grades groups classified by Working formulation revealed statistically significant differences of S-phase fraction and nuclear areas between each group.
CONCLUSION
The S-phase fraction and nuclear area measurement could be good diagnostic and prognostic factors in classification and clinical management of non-Hodgkin lymphoma.