{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:30:54Z","timestamp":1786681854772,"version":"build-2736575974"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008478","name":"Wake Forest School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>TP53<\/jats:italic>\n                      mutational status (\n                      <jats:italic>TP53<\/jats:italic>\n                      ms) is prognostically important in myeloid neoplasms. Immunohistochemistry (IHC) of p53 has been used as a surrogate for\n                      <jats:italic>TP53<\/jats:italic>\n                      mutations, with faster results than next-generation sequencing (NGS) and cytogenetic analysis. Given the challenges posed by heterogeneous p53 IHC expression, this study aims to evaluate the interobserver interpretation of p53 stain as a surrogate marker for\n                      <jats:italic>TP53m<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Fifty-three bone marrow (BM) specimens previously diagnosed as myeloid neoplasms or nonneoplastic BM specimens with available concurrent\n                      <jats:italic>TP53ms<\/jats:italic>\n                      were evaluated. p53 IHC staining was performed on all 53 core biopsy or clot sections.\n                      <jats:italic>TP53<\/jats:italic>\n                      mutation was found in 24 cases (\n                      <jats:italic>TP53<\/jats:italic>\n                      m). Twenty-nine specimens were\n                      <jats:italic>TP53<\/jats:italic>\n                      wild-type and served as the control group. Six hematopathologists (HPs) blinded to the diagnosis and\n                      <jats:italic>TP53<\/jats:italic>\n                      m independently scored the p53 staining pattern of the biopsies\/clot sections for overall staining percentage (OSP) and staining intensity (dark staining percentage as a percentage of total cells (DCP)).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The intraclass correlation was excellent for OSP (0.927) and good for DCP (0.848). For OSP, a cutoff of 30% resulted in sensitivity of 83.3%, specificity of 89.7%, PPV of 87.0%, and NPV of 86.7%. For DCP, a cutoff of 10% achieved sensitivity of 87.5%, specificity of 96.6%, PPV of 95.4%, and NPV of 90.3%. Additionally, DCP significantly correlated with the VAF of\n                      <jats:italic>TP53<\/jats:italic>\n                      m (R\u00a0=\u00a00.469, p = 0.028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      High inter-rater reliability for OSP and DCP supports integrating p53 IHC into bone marrow evaluations for rapid\n                      <jats:italic>TP53<\/jats:italic>\n                      m assessment. With superior specificity and predictive values, DCP proves to be a more reliable diagnostic marker for\n                      <jats:italic>TP53<\/jats:italic>\n                      mutations. While this approach shows promise for myeloid neoplasms, further validation is needed to overcome challenges and expand its clinical utility for tailored treatment strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1916425","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:23:17Z","timestamp":1786681397000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Interpretation of p53 immunohistochemical stain of TP53-mutated myeloid neoplasms"],"prefix":"10.3389","volume":"16","author":[{"given":"Nawroz","family":"Barwari","sequence":"first","affiliation":[{"name":"Department of Pathology, Wake Forest University School of Medicine\/Atrium Health Wake Forest Baptist Medical Center","place":["Winston-Salem, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William 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