[Immunohistochemical method of megakaryocytic lineage staining in bone marrow biopsy specimens as an additional pathomorphological differential diagnostic sign of primary myelofibrosis and essential thrombocythemia].

Q4 Medicine
Z P Asaulenko, Yu A Krivolapov
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引用次数: 0

Abstract

Objective: To evaluate and compare morphometric and histotopographic characteristics of megakaryocytic lineage in preparations stained with H&E or antibodies to CD42b in diagnostic trepanobioptates of bone marrow of patients with primary myelofibrosis and essential thrombocythemia with JAK2 or CALR mutation. Analyze the dimensions and quantity of CD42b-positive megakaryocytes in 1 mm2 area of section and assess suitability of these parameters as an additional differential pathomorphological criterion.

Material and methods: 108 trephine biopsies of the bone marrow from patients with primary myelofibrosis (N=53) and essential thrombocythemia (N=55) with JAK2 or CALR mutation were selected. Digitized bone marrow slides stained with H&E or antibodies to CD42b (clone EP409) were the object of study. In every sample the average values of perimeter and area of megakaryocytes were analyzed, as well as the average number of megakaryocytes in 1 mm2 area of myeloid tissue section. Logistic regression analysis was used to describe the relationship between CD42b-positive megakaryocyte characteristics and disease (primary myelofibrosis or essential thrombocythemia).

Results: Immunohistochemical examination of bone marrow biopsy specimens using antibodies to CD42b in comparison with H&E staining allows to multiply the number of identifiable megakaryocytes in myeloid tissue by 3.5-4 times (p<0.0001). Statistically significant differences in the mean values of the number of megakaryocytes in 1 mm2 of the section area and megakaryocyte perimeter in patients with primary myelofibrosis and essential thrombocythemia have been demonstrated. ROC analysis (AUC=0.84, 95% CI 0.7782-0.9199) justifies the inclusion of the average perimeter size of CD42b-positive megakaryocytes and their number in 1 mm2 of the section area in the differential diagnostic panel as an additional pathomorphological criterion.

Conclusion: The revealed statistically significant differences in quantitative and geometric characteristics of megakaryocytes allowed to calculate differential threshold values of characteristics of megakaryocytic lineage of myeloid tissue in diagnostic trepanobioptates of bone marrow from patients with primary myelofibrosis and essential thrombocythemia. Counting the number of CD42b-positive megakaryocytes in one field of view at a magnification of 400 times was proposed as an additional pathomorphological differential-diagnostic sign.

[骨髓活检标本中巨核细胞谱系染色的免疫组织化学方法作为原发性骨髓纤维化和原发性血小板增多症的附加病理形态学鉴别诊断标志]。
目的:评价和比较H&E染色或CD42b抗体对JAK2或CALR突变原发性骨髓纤维化和原发性血小板增多症患者诊断性骨髓trepanobtates的巨核细胞谱系形态学和组织形态学特征。分析切片1mm2区域内cd42b阳性巨核细胞的尺寸和数量,并评估这些参数作为附加病理形态学鉴别标准的适用性。材料和方法:选择JAK2或CALR突变的原发性骨髓纤维化(N=53)和原发性血小板增多症(N=55)患者108例骨髓穿刺活检。以H&E或CD42b抗体(克隆EP409)染色的数字化骨髓玻片为研究对象。在每个样本中分析巨核细胞周长和面积的平均值,以及骨髓组织切片1 mm2面积内巨核细胞的平均数量。采用Logistic回归分析来描述cd42b阳性巨核细胞特征与疾病(原发性骨髓纤维化或原发性血小板增多症)之间的关系。结果:与H&E染色相比,使用CD42b抗体对骨髓活检标本进行免疫组化检查,可以将原发性骨髓纤维化和原发性血小板增多症患者骨髓组织中可识别的巨核细胞数量增加3.5-4倍(p2)的切片面积和巨核细胞周长。ROC分析(AUC=0.84, 95% CI 0.7782-0.9199)证明将cd42b阳性巨核细胞的平均周长及其在1 mm2切片面积内的数量作为鉴别诊断面板的附加病理形态学标准是合理的。结论:所揭示的巨核细胞数量和几何特征的统计学差异,允许计算骨髓组织巨核细胞谱系特征的差异阈值,用于诊断原发性骨髓纤维化和原发性血小板增多症患者的骨髓trepanobioptates。在400倍的放大镜下,在一个视场内计数cd42b阳性巨核细胞的数量被提议作为一个额外的病理形态学鉴别诊断标志。
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来源期刊
Arkhiv patologii
Arkhiv patologii Medicine-Pathology and Forensic Medicine
CiteScore
0.90
自引率
0.00%
发文量
55
期刊介绍: The journal deals with original investigations on pressing problems of general pathology and pathologic anatomy, newest research methods, major issues of the theory and practice as well as problems of experimental, comparative and geographic pathology. To inform readers latest achievements of Russian and foreign medicine the journal regularly publishes editorial and survey articles, reviews of the most interesting Russian and foreign books on pathologic anatomy, new data on modern methods of investigation (histochemistry, electron microscopy, autoradiography, etc.), about problems of teaching, articles on the history of pathological anatomy development both in Russia and abroad.
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