Lones Mark A, Raphael Martine, Perkins Sherrie L, Wotherspoon Andrew, Auperin Anne, Terrier-Lacombe Marie-Jose, Sposto Richard, Weston Claire, Gerrard Mary, Patte Catherine, Cairo Mitchell S, McCarthy Keith
Children's Cancer Group (CCG) (now part of Children's Oncology Group), Operations Center, 440 E. Huntington Drive, PO Box 60012, Arcadia, CA 91066-6012, USA.
J Pediatr Hematol Oncol. 2006 Sep;28(9):568-74. doi: 10.1097/01.mph.0000212980.67114.a5.
In pediatric mature B-cell non-Hodgkin lymphoma, international pathologist diagnostic agreement was previously evaluated using the Revised European-American Lymphoma Classification. Surgical biopsy histology technical quality (HTQ) is variable and may affect diagnostic accuracy. This study evaluated diagnostic agreement correlated with HTQ. Surgical biopsies obtained from international protocol FAB LMB96 Treatment of Mature B-Cell Lymphoma/Leukemia for Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL), and high-grade B-cell lymphoma Burkitt-like (BLL), were independently reviewed by hematopathologists from 3 national groups (Children's Cancer Group, Société Française d'Oncologie Pédiatrique, and United Kingdom Children's Cancer Study Group) to determine each national diagnosis and a final diagnosis. HTQ grades for microscopic tissue sections included: good; medium; low; inconclusive. Final diagnoses in 187 cases included: BL 87 (47%); BLL 20 (11%); DLBCL 64 (34%); other 16 (9%). HTQ grades included: good 10 (5%); medium 100 (54%); low 75 (40%); inconclusive 2 (1%). The rate of uniform agreement between the national diagnoses was significantly higher with good or medium HTQ (62%) than with low HTQ (33%) (P = 0.001). In conclusion, in pediatric mature B-cell non-Hodgkin lymphoma, international pathologist diagnostic agreement is significantly higher in surgical biopsies with better HTQ. Poor HTQ may adversely impact diagnostic ability and affect prognosis and therapeutic management when different treatment regimens are employed for DLBCL versus BL/BLL.
在儿童成熟B细胞非霍奇金淋巴瘤中，以往曾使用修订后的欧美淋巴瘤分类评估国际病理学家的诊断一致性。手术活检组织学技术质量（HTQ）存在差异，可能会影响诊断准确性。本研究评估了与HTQ相关的诊断一致性。从国际方案FAB LMB96治疗成熟B细胞淋巴瘤/白血病中获取的用于伯基特淋巴瘤（BL）、弥漫性大B细胞淋巴瘤（DLBCL）和高级别B细胞伯基特样淋巴瘤（BLL）的手术活检标本，由3个国家的血液病理学家小组（儿童癌症组、法国儿科肿瘤学会和英国儿童癌症研究组）进行独立审查，以确定每个国家的诊断结果和最终诊断。显微镜组织切片的HTQ分级包括：良好；中等；差；不确定。187例病例的最终诊断包括：BL 87例（47%）；BLL 20例（11%）；DLBCL 64例（34%）；其他16例（9%）。HTQ分级包括：良好10例（5%）；中等100例（54%）；差75例（40%）；不确定2例（1%）。HTQ良好或中等时，国家诊断之间的一致率（62%）显著高于HTQ差时（33%）（P = 0.001）。总之，在儿童成熟B细胞非霍奇金淋巴瘤中，HTQ较好的手术活检中，国际病理学家的诊断一致性显著更高。HTQ差可能会对诊断能力产生不利影响，并在针对DLBCL与BL/BLL采用不同治疗方案时影响预后和治疗管理。
