使用诊断测试结果组合更准确地诊断脉络膜视网膜淋巴瘤：一项前瞻性观察研究。
More Accurate Diagnosis of Vitreoretinal Lymphoma Using a Combination of Diagnostic Test Results: A Prospective Observational Study.
机构信息
Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan.
Department of Ophthalmology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
出版信息
Ocul Immunol Inflamm. 2022 Aug;30(6):1354-1360. doi: 10.1080/09273948.2021.1873394. Epub 2021 Apr 1.
PURPOSE
To establish diagnostic criteria for vitreoretinal lymphoma (VRL) using cytology and laboratory tests from vitreous samples: interleukin (IL)-10/IL-6 ratio, immunoglobulin (Ig) H gene rearrangement, and clonal B-cells on flow cytometry.
METHODS
Fifty-six patients with and 39 without VRL were included. We assessed the sensitivity and specificity of each test and those of diagnostic criteria based on combinations of these tests.
RESULTS
The sensitivity values for malignant cytology, IL-10/IL-6 > 1, IgH gene rearrangement, and flow cytometry were 0.554, 0.821, 0.732, and 0.625 with specificity of 1.000, 1.000, 0.846, and 0.974, respectively. When the diagnostic criteria were set at malignant cytology or at two or more of of four tests (atypical cells, IL-10/IL-6 > 1, IgH gene rearrangement, and flow cytometry), the sensitivity and specificity values for accurate diagnosis were 0.929 and 1.00, respectively.
CONCLUSION
Malignant cytology or positive results for two or more of four tests may be adequate for VRL diagnosis.
目的
利用玻璃体样本细胞学和实验室检测（白细胞介素-10/白细胞介素-6 比值、免疫球蛋白 H 基因重排和流式细胞术上的克隆性 B 细胞）建立玻璃体视网膜淋巴瘤（VRL）的诊断标准。
方法
纳入 56 例 VRL 患者和 39 例非 VRL 患者。我们评估了每种检测方法以及基于这些检测方法组合的诊断标准的敏感性和特异性。
结果
恶性细胞学、白细胞介素-10/白细胞介素-6＞1、免疫球蛋白 H 基因重排和流式细胞术的敏感性值分别为 0.554、0.821、0.732 和 0.625，特异性值分别为 1.000、1.000、0.846 和 0.974。当诊断标准设定为恶性细胞学或四项检测中的两项或以上（异型细胞、白细胞介素-10/白细胞介素-6＞1、免疫球蛋白 H 基因重排和流式细胞术）时，准确诊断的敏感性和特异性值分别为 0.929 和 1.00。
结论
恶性细胞学或四项检测中的两项或以上阳性结果可能足以诊断 VRL。
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