AI Article Synopsis

  • - The study investigates olfactory neuroblastomas (ONBs), rare tumors in the nasal area, evaluating whether the Ki67 proliferation index (PI) and tumor-infiltrating lymphocytes (TILs) can serve as better prognostic markers than the outdated Hyams grading system.
  • - Researchers analyzed 45 cases, finding that higher Ki67 PI levels (≥25) indicated poorer survival rates, and that high-grade ONBs had increased intratumoral CD8+ and CD4+ lymphocytes.
  • - The study concludes that the Ki67 PI and TILs could provide valuable prognostic information for ONB patients, suggesting a shift from solely using the Hyams grading system.

Article Abstract

Aims: Olfactory neuroblastomas (ONBs) are rare malignant tumours that arise in the nasal vault. To date, the Hyams grade remains the only widely used histological grading system. However, it is based only on morphological criteria, and has not been updated since 1988. The objective of this study was to explore the prognostic potential of the Ki67 proliferation index (PI) and tumour-infiltrating lymphocytes (TILs) in ONB.

Methods And Results: A retrospective study was conducted on a bicentric series of 45 cases. The Ki67 PI was determined by counting at least 1000 nuclei on whole slides. TILs were evaluated with CD20, CD4 and CD8 immunohistochemical markers on whole slides. In this series, Hyams grades I, II, III and IV accounted for 13.4%, 44.4%, 20% and 22.2% of all cases, respectively. The Ki67 PI ranged from 1 to 93; the Ki67 PI was significantly higher in Hyams grade III-IV ONBs than in Hyams grade I-II ONBs (P < 0.0001). A Ki67 PI of ≥25 was associated with poorer survival (P = 0.02). TILs were present in both stromal and intratumoral compartments, but were located predominantly in the stromal component of the tumour. The numbers of intratumoral CD8+ cells/mm and CD4+ cells/mm were greater in high-grade ONBs than in low-grade ONBs (P = 0.0015 and P = 0.043, respectively). The numbers of T cells/mm and B cells/mm were not associated with survival, but a CD4/CD8 ratio of >2 was significantly associated with shorter survival (P = 0.04).

Conclusion: Our findings suggest that the Ki67 PI and TILs could be used as prognostic markers, as a potential alternative to the Hyams grade.

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http://dx.doi.org/10.1111/his.13954DOI Listing

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Introduction Olfactory neuroblastoma (ONB) is a rare malignant tumor of the upper nasal cavity. The Hyams classification is an important histological grading system for diagnosing recurrence and predicting survival in ONB. This study aimed to evaluate the utility of apparent diffusion coefficient (ADC) histogram analysis in distinguishing between high-grade and low-grade ONB based on the Hyams classification system.

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