Department of Hematology/Oncology, Division of Hematology.
Department of Medicine, Division of Hematology, McGill University, Jewish General Hospital-Sir Mortimer Davis, Montréal, QC, Canada.
Appl Immunohistochem Mol Morphol. 2020 Aug;28(7):508-512. doi: 10.1097/PAI.0000000000000787.
We aim to evaluate the degree of agreement between immunohistochemistry (IHC) and flow cytometry (FC) in the diagnosis of malignant hematologic diseases, mainly lymphomas. A total of 260 bone marrow biopsies, 255 bone marrow aspirates, and 5 other suspensions of 260 patients used for diagnosis of a hematologic malignancy between 2009 and 2012 with both, IHC and FC, were retrospectively analyzed. Overall there is a substantial degree of agreement (κ=0.69) between IHC and FC. Chronic lymphocytic leukemia/small lymphocytic lymphoma, mature T-cell neoplasms, acute leukemias, and myelodysplastic syndromes had the highest concurrence rates (>80%). In nonconcordant cases, an IHC provided diagnosis in 25.4%, and an FC in 4.6%. Lymphomas were diagnosed by an IHC only in 51% of the cases. Both methods have good concurrence rates and are complementary. An IHC has the advantage of combining markers, morphology, and tissue immunoarchitecture, which is beneficial in the diagnosis of lymphomas. An FC is required in leukemias as it is faster and plays an important role in minimal residual disease.
我们旨在评估免疫组织化学（IHC）和流式细胞术（FC）在恶性血液病（主要为淋巴瘤）诊断中的一致性程度。回顾性分析了 2009 年至 2012 年间 260 例患者的 260 例骨髓活检、255 例骨髓抽吸物和 5 例其他悬浮液，这些患者均同时进行了 IHC 和 FC 检测以诊断血液系统恶性肿瘤。总体而言，IHC 和 FC 之间具有高度一致性（κ=0.69）。慢性淋巴细胞白血病/小淋巴细胞淋巴瘤、成熟 T 细胞肿瘤、急性白血病和骨髓增生异常综合征的符合率最高（>80%）。在不一致的病例中，IHC 提供诊断的比例为 25.4%，FC 为 4.6%。淋巴瘤仅通过 IHC 诊断的比例为 51%。两种方法均具有较高的一致性，互为补充。IHC 具有结合标记物、形态和组织免疫架构的优势，有利于淋巴瘤的诊断。在白血病中需要进行 FC，因为它更快，在微小残留病的检测中发挥重要作用。
