高灵敏度的流式细胞术免疫表型可提高恶性胸腔积液的诊断率。

IF 4.2 3区 医学 Q2 ONCOLOGY
Clinical & Experimental Metastasis Pub Date : 2023-12-01 Epub Date: 2023-10-09 DOI:10.1007/s10585-023-10236-4
Dolores Subirá, Fabiola Barriopedro, Jesús Fernández, Ruth Martínez, Luis Chara, Jorge Castelao, Eugenia García
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引用次数: 0

摘要

当患者缺乏癌症病史且细胞病理学未检测到胸腔积液(PE)中的恶性细胞时,诊断恶性胸腔积液(MPE)是一项挑战。我们研究了通过流式细胞术免疫表型(FCI)对PE的系统分析是否对MPE的诊断率有任何影响。在7年多的时间里,来自临床怀疑MPE患者的570份样本被提交给FCI研究。为了筛选上皮恶性肿瘤,使用了三色FCI高灵敏度测定法。FCI结果被定性为“恶性”(FCI+)或“非恶性”(FCI-),与临床医生根据所有可用信息确定的综合明确诊断进行比较。在182个样本中最终诊断为MPE,检测到141/182(77.5%)的FCI。形态学通过对PE中恶性细胞的细胞病理学检测进一步证实了FCI的发现(n = 91)或组织病理学(n = 29)。影像学检查和临床病史支持其余样本的诊断。恶性细胞的中位百分比淋巴瘤为6.5%,继发于上皮细胞恶性肿瘤的MPE为0.23%。FCI发现EpCAM的百分比明显较低+ 细胞病理学阴性MPE中的细胞比细胞病理学阳性病例中的细胞多(0.02%vs.1%;p
本文章由计算机程序翻译,如有差异,请以英文原文为准。

High sensitivity flow cytometry immunophenotyping increases the diagnostic yield of malignant pleural effusions.

High sensitivity flow cytometry immunophenotyping increases the diagnostic yield of malignant pleural effusions.

Diagnosing malignant pleural effusions (MPE) is challenging when patients lack a history of cancer and cytopathology does not detect malignant cells in pleural effusions (PE). We investigated whether a systematic analysis of PE by flow cytometry immunophenotyping (FCI) had any impact on the diagnostic yield of MPE. Over 7 years, 570 samples from patients with clinical suspicion of MPE were submitted for the FCI study. To screen for epithelial malignancies, a 3-color FCI high sensitivity assay was used. The FCI results, qualified as "malignant" (FCI+) or "non-malignant" (FCI-), were compared to integrated definitive diagnosis established by clinicians based on all available information. MPE was finally diagnosed in 182 samples and FCI detected 141/182 (77.5%). Morphology further confirmed FCI findings by cytopathology detection of malignant cells in PE (n = 91) or histopathology (n = 29). Imaging tests and clinical history supported the diagnosis in the remaining samples. The median percentage of malignant cells was 6.5% for lymphoma and 0.23% for MPE secondary to epithelial cell malignancies. FCI identified a significantly lower percentage of EpCAM+ cells in cytopathology-negative MPE than in cytopathology-positive cases (0.02% vs. 1%; p < 0.0001). Interestingly, 29/52 MPE (55.8%) where FCI alerted of the presence of malignant cells were new diagnosis of cancer. Overall, FCI correctly diagnosed 456/522 samples (87.4%) suitable for comparison with cytopathology. These findings show that high sensitivity FCI significantly increases the diagnostic yield of MPE. Early detection of FCI + cases accelerates the diagnostic pathway of unsuspected MPE, thus supporting its implementation in clinical diagnostic work-up as a diagnostic tool.

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来源期刊
CiteScore
7.80
自引率
5.00%
发文量
55
审稿时长
12 months
期刊介绍: The Journal''s scope encompasses all aspects of metastasis research, whether laboratory-based, experimental or clinical and therapeutic. It covers such areas as molecular biology, pharmacology, tumor biology, and clinical cancer treatment (with all its subdivisions of surgery, chemotherapy and radio-therapy as well as pathology and epidemiology) insofar as these disciplines are concerned with the Journal''s core subject of metastasis formation, prevention and treatment.
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