Department of Veterinary Medicine and Epidemiology, UC Davis School of Veterinary Medicine, Davis, California.
Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas.
J Vet Intern Med. 2020 Mar;34(2):669-677. doi: 10.1111/jvim.15742. Epub 2020 Feb 26.
Differentiation of lymphocytic-plasmacytic enteropathy (LPE) from small cell lymphoma (SCL) in cats can be challenging.
HYPOTHESIS/OBJECTIVE: Histology-guided mass spectrometry (HGMS) is a suitable method for the differentiation of LPE from SCL in cats.
Forty-one cats with LPE and 52 cats with SCL.
This is a retrospective clinicopathologic study. Duodenal tissue samples of 17 cats with LPE and 22 cats with SCL were subjected to HGMS, and the acquired data were used to develop a linear discriminate analysis (LDA) machine learning algorithm. The algorithm was subsequently validated using a separate set of 24 cats with LPE and 30 cats with SCL. Cases were classified as LPE or SCL based on a consensus by an expert panel consisting of 5-7 board-certified veterinary specialists. Histopathology, immunohistochemistry, and clonality testing were available for all cats. The panel consensus classification served as a reference for the calculation of test performance parameters.
Relative sensitivity, specificity, and accuracy of HGMS were 86.7% (95% confidence interval [CI]: 74.5%-98.8%), 91.7% (95% CI: 80.6%-100%), and 88.9% (95% CI: 80.5%-97.3%), respectively. Comparatively, the clonality testing had a sensitivity, specificity, and accuracy of 85.7% (95% CI: 72.8%-98.7%), 33.3% (95% CI: 14.5%-52.2%), and 61.5% (95% CI: 48.3%-74.8%) relative to the panel decision.
Histology-guided mass spectrometry was a reliable technique for the differentiation of LPE from SCL in duodenal formalin-fixed paraffin-embedded samples of cats and might have advantages over tests currently considered state of the art.
区分猫的淋巴细胞浆细胞性肠病(LPE)和小细胞淋巴瘤(SCL)具有挑战性。
假设/目的:组织学引导的质谱(HGMS)是区分猫的 LPE 和 SCL 的合适方法。
41 只患有 LPE 的猫和 52 只患有 SCL 的猫。
这是一项回顾性临床病理研究。17 只患有 LPE 的猫和 22 只患有 SCL 的猫的十二指肠组织样本接受了 HGMS,获得的数据用于开发线性判别分析(LDA)机器学习算法。该算法随后使用一组 24 只患有 LPE 和 30 只患有 SCL 的猫进行了验证。根据由 5-7 名董事会认证兽医专家组成的专家小组的共识,对病例进行 LPE 或 SCL 分类。所有猫均具有组织病理学、免疫组织化学和克隆性检测结果。专家组共识分类作为计算测试性能参数的参考。
HGMS 的相对敏感性、特异性和准确性分别为 86.7%(95%置信区间[CI]:74.5%-98.8%)、91.7%(95%CI:80.6%-100%)和 88.9%(95%CI:80.5%-97.3%)。相比之下,克隆性检测的敏感性、特异性和准确性分别为 85.7%(95%CI:72.8%-98.7%)、33.3%(95%CI:14.5%-52.2%)和 61.5%(95%CI:48.3%-74.8%),与专家组决策相比。
组织学引导的质谱是区分猫十二指肠福尔马林固定石蜡包埋样本中 LPE 和 SCL 的可靠技术,可能优于目前被认为是最先进的检测方法。