Ensani Fereshteh, Mehravaran Sepideh, Irvanlou Giti, Aghaipoor Mahnaz, Vaeli Shahram, Hajati Esmerdis, Khorgami Zhamak, Nasiri Shirzad
Cancer Institute Research Center and Pathology Department, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Diagn Cytopathol. 2012 Apr;40(4):305-10. doi: 10.1002/dc.21561. Epub 2010 Nov 12.
This prospective study aimed to compare the value of fine needle aspiration (FNA) cytology (FNAC) and flow cytometric immunophenotyping (FCI) with histopatopathology (HP) in the diagnosis and classification of non-Hodgkin lymphoma (NHL). Twenty-nine excised lymph nodes suspected of NHL were evaluated using FNAC, FCI, and HP. Specimens were divided into two equal parts; one for HP and the other for FNAC and FCI. Results were compared in terms of diagnosis (malignant, benign or reactive, and metastatic) and NHL class. With combined FNAC/FCI, 11 (37.9%) cases were diagnosed as NHL, 11 cases (37.9%) as reactive lymph node, six cases (20.6%) as Hodgkin's lymphoma, and one case (3.4%) as metastasis. HP revealed nine cases (31%) of NHL, five cases (17.2%) of reactive lymph nodes and all the diagnosed metastatic and Hodgkin's lymphoma. Considering histology as a gold standard method in diagnosis, the sensitivity, specificity, PPV and NPV of FNAC/FCI in differentiate malignant and benign lesion were 73.9%, 83.3%, 94.4%, and 45.5%, respectively and in differentiate NHL from others were 75%, 93.8%, 90%, and 83.3%, respectively. Cytology and HP in addition to FCI and HP are significantly different from determination of NHL lesions point of view (P = 0.001 and P < 0.0001, respectively). However, FCI can be considered as an adjunctive method for Cytology especially because Cytology is not competent enough to differentiate between benign lesions and Lymphoma. Additionally, FCI is shown to be an accurate method in classifying NHL.
这项前瞻性研究旨在比较细针穿刺（FNA）细胞学检查（FNAC）和流式细胞免疫表型分析（FCI）与组织病理学（HP）在非霍奇金淋巴瘤（NHL）诊断和分类中的价值。对29个疑似NHL的切除淋巴结进行了FNAC、FCI和HP评估。标本被分成两等份；一份用于HP检查，另一份用于FNAC和FCI检查。从诊断（恶性、良性或反应性以及转移性）和NHL类别方面对结果进行了比较。联合使用FNAC/FCI时，11例（37.9%）被诊断为NHL，11例（37.9%）为反应性淋巴结，6例（20.6%）为霍奇金淋巴瘤，1例（3.4%）为转移瘤。HP检查显示有9例（31%）NHL，5例（17.2%）反应性淋巴结以及所有诊断出的转移性和霍奇金淋巴瘤。将组织学视为诊断的金标准方法，FNAC/FCI在区分恶性和良性病变时的敏感性、特异性、阳性预测值和阴性预测值分别为73.9%、83.3%、94.4%和45.5%，在区分NHL与其他疾病时分别为75%、93.8%、90%和83.3%。从确定NHL病变的角度来看，细胞学检查以及FCI和HP之间存在显著差异（分别为P = 0.001和P < 0.0001）。然而，FCI可被视为细胞学的辅助方法，特别是因为细胞学在区分良性病变和淋巴瘤方面能力不足。此外，FCI在NHL分类中是一种准确的方法。
