Zeppa P, Vigliar E, Cozzolino I, Troncone G, Picardi M, De Renzo A, Grimaldi F, Pane F, Vetrani A, Palombini Lucio
Dipartimenti di Scienze Biomorfologiche e Funzionali, Facoltà di Medicina e Chirurgia, Università di Napoli "Federico II", Napoli, Italia.
Cytopathology. 2010 Oct;21(5):300-10. doi: 10.1111/j.1365-2303.2009.00725.x. Epub 2010 Feb 1.
To evaluate the diagnostic efficiency of fine needle aspiration cytology/flow cytometry (FNAC/FC) in the diagnosis and classification of non-Hodgkin lymphoma (NHL) in a series of 446 cases and to compare the results with those of previous experiences to evaluate whether there had been an improvement in FNAC/FC diagnostic accuracy.
FNAC/FC was used to analyse 446 cases of benign reactive hyperplasia (BRH), NHL and NHL relapse (rNHL) in 362 lymph nodes and 84 extranodal lesions. When a diagnosis of NHL was reached, a classification was attempted combining FC data and cytological features. Sensitivity, specificity and positive and negative predictive values (PPV and NPV) of FNAC/FC in the diagnosis and classification of NHL were calculated and compared with those available in the literature.
FNAC/FC provided a diagnosis of NHL and rNHL in 245 cases and of BRH in 188 cases. In nine cases, the diagnosis was 'suggestive of NHL' (sNHL) and in four cases was inadequate. Histology and clinical follow-up confirmed 102 cases of NHL and detected one false positive. In 18 cases of BRH diagnosed by FNAC/FC, histological examination revealed 14 BRH and four NHL (false negatives). All nine cases diagnosed as sNHL were confirmed by histology. Including sNHL cases as false negatives, statistical analysis showed 94.9% sensitivity, 99.4% specificity, 99.6% PPV and 93.4% NPV in the diagnosis of NHL. A specific subtype was diagnosed in 125 cases and confirmed in 67 of 70 cases that had histological biopsies. Statistical analysis did not demonstrate significant improvements between the present series and previous studies either in diagnosis or in classification of NHL.
FNAC/FC is a fundamental tool in the diagnosis and classification of NHL but the exiguity of diagnostic material and other technical and clinical limitations will probably continue to limit further improvement of the technique.
评估细针穿刺细胞学检查/流式细胞术（FNAC/FC）对446例非霍奇金淋巴瘤（NHL）的诊断及分类效率，并将结果与既往经验进行比较，以评估FNAC/FC诊断准确性是否有所提高。
采用FNAC/FC分析362个淋巴结及84个结外病变中的446例良性反应性增生（BRH）、NHL及NHL复发（rNHL）病例。确诊为NHL后，尝试结合FC数据及细胞学特征进行分类。计算FNAC/FC在NHL诊断及分类中的敏感性、特异性、阳性及阴性预测值（PPV和NPV），并与文献中的数据进行比较。
FNAC/FC诊断出245例NHL及rNHL，188例BRH。9例诊断为 “疑似NHL”（sNHL），4例诊断不充分。组织学检查及临床随访确诊102例NHL，发现1例假阳性。在FNAC/FC诊断为BRH的18例中，组织学检查显示14例为BRH，4例为NHL（假阴性）。所有9例诊断为sNHL的病例均经组织学确诊。将sNHL病例计为假阴性，统计分析显示NHL诊断的敏感性为94.9%，特异性为99.4%，PPV为99.6%，NPV为93.4%。125例诊断出特定亚型，在70例进行组织学活检的病例中，67例得到证实。统计分析未显示本系列研究与既往研究在NHL诊断或分类方面有显著改善。
FNAC/FC是NHL诊断及分类的重要工具，但诊断材料有限以及其他技术和临床限制可能会继续限制该技术的进一步改进。
