{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:28:11Z","timestamp":1782167291101,"version":"3.54.5"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T00:00:00Z","timestamp":1701648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002494"],"award-info":[{"award-number":["UL1TR002494"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Novel histopathologic prognostic factors are needed to identify patients with follicular lymphoma (FL) at risk of inferior outcomes. Our primary objective was to evaluate the Ki-67 proliferative index in follicular and interfollicular areas in tissue biopsy specimens from patients with newly diagnosed FL and correlate with clinical outcomes. Our secondary objective was to correlate PD-L1 and LAG-3 with clinical outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Seventy cases of low-grade FL from the University of Minnesota were evaluated with Ki-67 immunohistochemical stain. Ki-67 expression as a continuous variable was interpreted digitally and manually in follicular and interfollicular areas. Progression-free survival (PFS) and overall survival (OS) were analyzed by Cox regression, and hazard ratios (HRs) per 10-point increase in Ki-67 were calculated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Progression-free survival at 4 years was 28% (95% CI, 19%-41%). Interfollicular, but not follicular, Ki-67 was associated with PFS by manual (HR, 1.33; P = .01) and digital (HR, 1.38; P = .02) analysis. Digital and manual Ki-67 were only moderately correlated but demonstrated similar effects on PFS. At 4 years, OS was 90% with no association with follicular or interfollicular Ki-67 proliferation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Higher interfollicular Ki-67 by either digital or manual analysis is associated with a poorer PFS in patients with low-grade FL. These results suggest further validation of this marker is warranted to improve pathologic risk stratification at FL diagnosis. PD-L1 and LAG-3 were not associated with PFS or OS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqad161","type":"journal-article","created":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T07:50:26Z","timestamp":1701676226000},"page":"380-387","source":"Crossref","is-referenced-by-count":3,"title":["Digital and manual interfollicular Ki-67 are associated with a progression-free survival in patients with low-grade follicular lymphoma"],"prefix":"10.1093","volume":"161","author":[{"given":"Aqsa","family":"Nasir","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, MN ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livia","family":"Hegerova","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, University of Washington Department of Medicine, Division of Hematology , Seattle, WA ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hira","family":"Yousaf","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, MN ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen L","family":"Forster","sequence":"additional","affiliation":[{"name":"BioNet, Biorepository and Laboratory Services, University of Minnesota , Minneapolis, MN ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Shanley","sequence":"additional","affiliation":[{"name":"Masonic Cancer Center Biostatistic Core, Department of Biostatistics, University of Minnesota , Minneapolis, MN ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Linden","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, MN ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Bachanova","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Minnesota , Minneapolis, MN ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2235-9930","authenticated-orcid":false,"given":"Sophia","family":"Yohe","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, MN ,","place":["US"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,4]]},"reference":[{"key":"2024101708285941400_CIT0001","first-page":"2055","article-title":"Follicular lymphoma: evolving therapeutic strategies","volume-title":"Blood.","author":"Kahl","year":"2016"},{"key":"2024101708285941400_CIT0002","first-page":"1490","article-title":"Low histologic grade 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lymphomas","volume-title":"Blood.","author":"Xu-Monette","year":"2018"},{"key":"2024101708285941400_CIT0017","first-page":"1696","article-title":"An IL-27\/Stat3 axis induces expression of programmed cell death 1 ligands (PD-L1\/2) on infiltrating macrophages in lymphoma","volume-title":"Cancer Sci.","author":"Horlad","year":"2016"}],"container-title":["American Journal of Clinical 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