ArticleNeuro-oncology2015
Better see to better agree: phosphohistone H3 increases interobserver agreement in mitotic count for meningioma grading and imposes new specific thresholds.
Article in Neuro-oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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24 citing papers in PubMed, 52 citations in OpenAlex.
- BET inhibitor in combination with BCG vaccine enhances antitumor efficacy and orchestrates T cell reprogramming for melanoma.Cell reports. Medicine · 2025Article
- Information mismatch in PHH3-assisted mitosis annotation leads to interpretation shifts in H&E slide analysis.Scientific reports · 2024Article
- Enhancing mitosis quantification and detection in meningiomas with computational digital pathology.Acta neuropathologica communications · 2024Article
- Prognostic importance of mitosis quantification and PHH3 expression in oral epithelial dysplasia.Virchows Archiv : an international journal of pathology · 2024Article
- Predictive Power of MIB-1 vs. Mitotic Count on Progression-Free Survival in Skull-Base Meningioma.Cancers · 2022Article
- Role of proliferative marker index and KBTBD4 mutation in the pathological diagnosis of pineal parenchymal tumors.Brain tumor pathology · 2022Article
- Clinical Implications of the Mitotic Index as a Predictive Factor for Malignant Transformation of Atypical Meningiomas.Journal of Korean Neurosurgical Society · 2022Article
- Mitotic Activity in Gastrointestinal Stromal Tumors: Can we use Phosphohistone H3 Immunohistochemistry Instead of Hematoxylin and Eosin for Mitotic Count?Sisli Etfal Hastanesi tip bulteni · 2022Article
- The Utility of Phosphohistone H3 in Inter-Observer Variability of Mitotic Count in Meningioma, is There Any Benefit?Asian Pacific journal of cancer prevention : APJCP · 2021Article
- The histopathological diagnosis of atypical meningioma: glass slide versus whole slide imaging for grading assessment.Virchows Archiv : an international journal of pathology · 2021Article
- Article
- Accurate likelihood inference for the volume under the ROC surface.Cancer reports (Hoboken, N.J.) · 2020Article
- Clinical and histopathological predictors of outcome in malignant meningioma.Neurosurgical review · 2020Article
- Validation of mitotic cell quantification via microscopy and multiple whole-slide scanners.Diagnostic pathology · 2019Article
- Prognostic Characterization of Higher-Grade Meningiomas: A Histopathological Score to Predict Progression and Outcome.Journal of neuropathology and experimental neurology · 2019Article
- Phosphohistone H3 (PHH3) as a surrogate of mitotic figure count for grading in meningiomas: a comparison of PHH3 (S10) versus PHH3 (S28) antibodies.Virchows Archiv : an international journal of pathology · 2019Article
- Pathological prognostic markers in central nervous system solitary fibrous tumour/hemangiopericytoma: Evidence from a small series.PloS one · 2018Article
- BAP1 mutations in high-grade meningioma: implications for patient care.Neuro-oncology · 2017Review
- Article
- Can PPH3 be helpful to assess the discordant grade in primary and metastatic enteropancreatic neuroendocrine tumors?Endocrine · 2016Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMitotic count on hematoxylin and eosin (H&E)-stained slides is a crucial diagnostic criterion in meningioma grading. However, mitosis assessment on H&E slides can be impaired by technical factors and by pathologist's experience. Phosphohistone H3 (PHH3) serine-10 is a mitosis-specific antibody that has proven to facilitate mitotic count in various tumors.
methodsA series of 70 meningiomas (15 grade I, 40 grade II, 15 grade III) was used to validate PHH3 intra- and interobserver reproducibility and to identify PHH3-specific mitotic thresholds. Four pathologists with different experience in neuropathology counted mitoses on both H&E- and PHH3-stained slides.
resultsH&E and PHH3 mitotic rates were highly correlated (Pearson's r = 0.92, P < .0001). PHH3 mitotic counts had both a good mean interobserver correlation (R(m) = 0.83) and a good intraclass correlation (0.78), higher than H&E mitotic indices (R(m) = 0.77, intraclass correlation = 0.71). After further stratification of meningiomas according to World Health Organization grade, PHH3 performed better in terms of interobserver concordance (Kendall's W = 0.761) compared with H&E (Kendall's W = 0.697). Referring to the same meningioma groups identified by World Health Organization grade as the gold standard, the volume under the receiver operator characteristic surface was 0.91, indicating a very good diagnostic ability of PHH3 scores in discriminating the 3 meningioma groups. The 2 optimal PHH3-specific cutoff values were 6.61 and 22.02.
conclusionPHH3 staining is a useful diagnostic complementary tool to standard H&E mitotic count, optimizing intra- and interobserver reproducibility. PHH3-specific mitotic thresholds should be adopted to avoid overgrading of meningioma when ancillary methods are employed.
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