成熟 B 细胞非霍奇金淋巴瘤累及骨髓和外周血的免疫表型分析：在一家三级癌症医院的批判性分析和获得的见解。

Immunophenotyping of mature B-cell non Hodgkin lymphoma involving bone marrow and peripheral blood: critical analysis and insights gained at a tertiary care cancer hospital.

机构信息

Department of Pathology, Tata Memorial Hospital, Mumbai, India.

出版信息

Leuk Lymphoma. 2009 Aug;50(8):1290-300. doi: 10.1080/10428190903064824.

DOI:10.1080/10428190903064824

PMID:19811331

Abstract

We evaluated the diagnostic utility of flow cytometry immunophenotyping in bone marrow aspirates and peripheral blood, in the assessment of mature B-cell non-Hodgkin lymphoma (MBNHL). We analyzed 356 cases of MBNHL received for immunophenotyping over a 4 year period. All cases were reviewed, correlated with biopsy specimen (lymph node and splenectomy). Discrepant cases were re-evaluated. Common subtypes included chronic lymphocytic leukemia (CLL) (243 cases, 68.5%), follicular lymphoma (30 cases, 8.5%), mantle cell lymphoma (20 cases, 5.5%), splenic marginal zone lymphoma (18 cases, 5%), hairy cell leukemia (18 cases, 5%). CD5+/CD23+ had a high positive predictive value (PPV) for diagnosing CLL whereas CD5+/CD23- had a high negative predictive value (NPV) for diagnosing mantle-cell lymphoma (MCL). Limited panel of 9 antibodies mainly CD19, CD5, CD23, CD10, FMC7, kappa, lambda, CD3 and CD20 help diagnose more than 92% of cases of MBNHL. Minimal diagnostic panels become important in countries with limited resources.

摘要

我们评估了流式细胞术免疫表型分析在骨髓抽吸物和外周血中的诊断效用，用于评估成熟 B 细胞非霍奇金淋巴瘤（MBNHL）。我们分析了在 4 年期间接受免疫表型分析的 356 例 MBNHL 病例。所有病例均与活检标本（淋巴结和脾切除术）进行了回顾性比较。对有差异的病例进行了重新评估。常见亚型包括慢性淋巴细胞白血病（CLL）（243 例，68.5%）、滤泡性淋巴瘤（30 例，8.5%）、套细胞淋巴瘤（20 例，5.5%）、脾脏边缘区淋巴瘤（18 例，5%）、毛细胞白血病（18 例，5%）。CD5+/CD23+对诊断 CLL 具有较高的阳性预测值（PPV），而 CD5+/CD23-对诊断套细胞淋巴瘤（MCL）具有较高的阴性预测值（NPV）。9 种主要的抗体（CD19、CD5、CD23、CD10、FMC7、kappa、lambda、CD3 和 CD20）的有限组合有助于诊断超过 92%的 MBNHL 病例。在资源有限的国家，最小诊断组合变得非常重要。