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猫科动物结外淋巴瘤的细胞学:免疫表型预测的观察者间一致性低且准确性差异大。

Cytology of Feline Nodal Lymphoma: Low Interobserver Agreement and Variable Accuracy in Immunophenotype Prediction.

机构信息

Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Milan, Italy; Veterinary Teaching Hospital, University of Milan, Milan, Italy.

Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Milan, Italy; Veterinary Teaching Hospital, University of Milan, Milan, Italy.

出版信息

J Comp Pathol. 2021 Apr;184:1-6. doi: 10.1016/j.jcpa.2021.01.007. Epub 2021 Feb 22.

Abstract

Nodal lymphomas are less common in cats than in dogs and, consequently, no specific studies have been published. Cytology is the first step in the diagnosis of nodal lymphoma but is highly subjective. Morphological features have been introduced for the cytological classification of canine lymphomas but not for cats. Therefore, the aim of this study was to evaluate interobserver agreement on various cytological features of feline nodal lymphomas and to investigate the accuracy in predicting B or T immunophenotypes. Four veterinary cytologists examined 25 feline nodal and mediastinal lymphoma cytological samples by adapting the criteria used for the evaluation of canine lymphomas and setting histopathology and immunohistochemistry as the gold standard. High interobserver variability was found in the evaluation of most features except for the presence or absence of cytoplasmic vacuoles, which were more common in B-cell lymphomas. Cytology training centre was the major factor influencing the extent of agreement among evaluators. Diagnostic accuracy in predicting lymphoma immunophenotype varied from 35% to 75% and did not appear to be correlated with the experience of the evaluators. We conclude that cytological criteria, commonly used to describe canine lymphomas, are not adaptable to the counterpart feline neoplasms. Cytology-based immunophenotyping of feline lymphomas from different laboratories, and different cytologists within the same laboratory, differ substantially and should not be considered reliable. Specific cytological criteria are needed to describe feline lymphoma.

摘要

猫的淋巴结肿瘤比犬少见,因此,尚未有专门针对猫的此类疾病的研究。细胞学检查是诊断淋巴结肿瘤的第一步,但主观性较强。犬科淋巴瘤的细胞学分类引入了形态学特征,但猫科未引入。因此,本研究旨在评估不同猫科淋巴结淋巴瘤细胞学特征的观察者间一致性,并研究预测 B 或 T 免疫表型的准确性。4 位兽医细胞学专家通过采用评估犬科淋巴瘤的标准,检查了 25 例猫科淋巴结和纵隔淋巴瘤细胞学样本,并将组织病理学和免疫组织化学作为金标准。除细胞质空泡的存在或不存在外,评估大多数特征的观察者间差异很大,而细胞质空泡在 B 细胞淋巴瘤中更为常见。细胞学培训中心是影响评估者间一致性程度的主要因素。预测淋巴瘤免疫表型的诊断准确性从 35%到 75%不等,似乎与评估者的经验无关。我们得出结论,常用于描述犬科淋巴瘤的细胞学标准不适用于猫科肿瘤。来自不同实验室和同一实验室不同细胞学专家的基于细胞学的猫科淋巴瘤免疫表型存在显著差异,不应被认为是可靠的。需要特定的细胞学标准来描述猫科淋巴瘤。

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