Clinical Follow-up Demonstrates Differential Accuracy of Flow Cytometry and Cytomorphology for the Detection of Hematologic Malignancy in Hypercellular Body Cavity Fluids
| Autor: | Roberto Cairoli, Maurizio Faleri, Silvia Cantoni, Barbara Scarpati, Clara Cesana, Elisabetta Volpato, Claudia Barba, Ursula Ferri, Enrica Morra, Giuliana Lando, Annamaria Nosari, Linda Scampini, Bruno Brando, Giambattista Bertani, Catherine Klersy |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Pathology Lung medicine.diagnostic_test Pleural effusion business.industry Immunology Cell Biology Hematology Hyperplasia medicine.disease Biochemistry Gastroenterology Lymphoma Flow cytometry Bronchoalveolar lavage medicine.anatomical_structure Internal medicine medicine Hematologic malignancy Primary effusion lymphoma business |
| Zdroj: | Blood. 114:5018-5018 |
| ISSN: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood.v114.22.5018.5018 |
| Popis: | Abstract 5018 Flow cytometry (FCM) and cytomorphology (CM) evaluation of hematologic malignancy in hypercellular body cavity fluids (BCF) needs clinical validation and standardized approaches for definitive sample assessment. A total of 1,011 hypercellular BCF analyzed by FCM between 2002 and 2009 were retrospectively examined. As a prerequisite for inclusion in the study, each of the following was needed: suspected or known hematologic malignancy at withdrawal, CM performed on the same sample, and availability of follow-up data for reliable retrospective clinical outcome (RCO). Ninety-two BCF [61 effusions, 31 bronchoalveolar lavage fluids (BALF)] were selected for the analysis. Results obtained by the two methods were matched with RCO. A combined method assessment (CMA) was also tested, accounting as negative those samples not assessed as frankly positive by at least one method. Thirty-six percent of BCF resulted RCO-positive. By applying each method to RCO, concordant results between FCM and CM were observed in 69 cases (75%). Fifty-six cases (61%) were double true negative (TN), 11 cases (12%) were double true positive (TP), and 2 cases (2%) were double false negative (FN). The latter were BALF samples from patients with primary pulmonary lymphomatoid granulomathosis in which FCM revealed a prominent inflammatory background of CD3+ T-cells; clonality could not be assessed due to the small number of B-cells. Mismatched results between FCM and CM were observed in 23 cases (25%). FCM gave TP results in 19 cases (20.5%) with FN or uncertain CM, TN results in 3 cases (3%) with uncertain CM, and FN results in 1 case (1%) with TP CM. This was a pleural effusion in which, in the presence of anaplastic cell features, primary effusion lymphoma was definitively diagnosed by immunocytochemical staining for ORF73/latent nuclear antigen-1 of HHV-8 on B-cell marker negative neoplastic cells. By applying the CMA to RCO, 59 TN results (64%), 31 TP results (33.5%) and 2 (double) FN results (2%) were obtained. Overall, 100% specificity and positive predictive value were detected for each method. FCM/CMA sensitivity was significantly higher than CM sensitivity (p In conclusion, clinical follow-up demonstrates FCM to retain significantly higher accuracy than CM in detecting hematologic malignancy contamination in both effusions and BALF, especially in the subset of differentiated lymphomas. Combining methods improves diagnostic performance almost completely by means of FCM. Disclosures No relevant conflicts of interest to declare. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|