Evaluation of Microvessel Density Using Light Microscopy Versus Computerized Image Analysis in Multiple Myeloma.
Naser Aboud, Todd W Kelley, Jeffrey R Jacobsen, Sheryl Tripp, Andy Wilson, Robyn Fenn, Sherrie L Perkins, Mohamed E Salama. ARUP Reference lab, salt lake city; University of Utah, Salt Lake city; St. Jude Children's Research Hospital, Memphis
Background: Emerging data suggest a prognostic value of angiogenesis in bone marrow in Multiple Myeloma (MM). However, most of studies used a quantitative evaluation of the microvessel density using a method, so-called hot-spot technique that was developed for characterization of angiogenesis in solid tumors. Given that solid neoplasms and the bone marrow have differences regarding the vascular structures and the distribution of microvessels, we evaluated performance of microvessel count done manually on light microscopy (MVP) and microvessel parameters obtained using computerized image analysis in the context of other prognostic and microenvironment factors.
Design: MM cases diagnosed in 2007-2008 with adequate materials were included in the study. Immunohistochemical stains for CD138 and CD34 were performed to highlight Plasma cells (PC) and vasculature, respectively. Adequately CD34 & CD138 stained bone marrow core biopsies were digitally scanned with the ScanScope® XT system (Aperio Technologies, Inc., Vista, CA) and areas with most abundant PC were analyzed via 'microvessel density algorithm. Parameters obtained from the algorithm including microvessel density (MVD), vessel perimeter (VP), total number of vessels (TV) and segments with vessels of various bin areas (0-15, 15-30, 30-50, 50-75, 75-100, and 100um2 increment up to 900 um2) were analyzed with regards to association / prediction of PC and other prognostic / microenvironment parameters. All statistical analyses were performed using SAS software, Version 9.1 of the SAS System.
Results: 46 patients (29 M) ranged in age between 41-78 y were included. Immunoglobulin subtypes and microenvironment parameters including mast cells & trabecular volume didn't correlate with PC. Microvessel density as measured by MVP, MVD, or TV, correlated significantly with the PC with p values of <.0001, 0.0018 and 0.006, respectively. MVP showed higher Pearson ranking as compared to VP and TV at 0.56, 0.45 and 0.40, respectively. MVD was the most tightly correlated parameter with disease stage. When ranked for predictive power for plasma cell number, the segment of blood vessel with cross-area of 400-500 um2 ranked higher for prediction of PC.
Conclusions: Both MVP and MVD significantly correlate with plasma cell number. MVP was the highest predictor according to Pearson correlation. MVD correlated better with the stage of the disease. Vessels within 400-500 um2 segment ranked the highest in predicting plasma cells number.
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 191, Tuesday Afternoon