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应用组织学指导的质谱分析法鉴别猫的淋巴细胞-浆细胞性肠病和小细胞淋巴瘤。

Differentiation of lymphocytic-plasmacytic enteropathy and small cell lymphoma in cats using histology-guided mass spectrometry.

机构信息

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.

出版信息

J Vet Intern Med. 2020 Mar;34(2):669-677. doi: 10.1111/jvim.15742. Epub 2020 Feb 26.

Abstract

BACKGROUND

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.

ANIMALS

Forty-one cats with LPE and 52 cats with SCL.

METHODS

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.

RESULTS

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.

CONCLUSIONS AND CLINICAL IMPORTANCE

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.

摘要

背景

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。

动物

41 只患有 LPE 的猫和 52 只患有 SCL 的猫。

方法

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。

结果

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。

结论和临床意义

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5852/7096630/1edf18aeb96a/JVIM-34-669-g001.jpg

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