流式细胞术在诊断double-hit淋巴瘤中价值不大

niwanmao

double-hit淋巴瘤（DHL）是指同时具有MYC和BCL2（或BCL6）两种异位的B细胞淋巴瘤，这类淋巴瘤很少见，但是恶性程度高，进展快，预后差。既往研究认为，流式细胞术上CD20和/或CD19表达降低在DHL中比较常见。本文作者对比了26例DHL和一些Burkitt淋巴瘤和弥漫大B细胞淋巴瘤的流式表型，发现只有少数DHL患者弱表达CD19和CD20，因此，流式对于诊断double-hit淋巴瘤的价值不大，还需要研究出更敏感、更特异的诊断指标。

Cytometry B Clin Cytom. 2013 Jan 22. doi: 10.1002/cyto.b.21076. [Epub ahead of print]  Flow cytometry is of limited utility in the early identification of "Double-hit" B-cell lymphomas.Platt MY   , Delelys ME   , Preffer FI   , Sohani AR   .SourceDepartment of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114. myplatt@partners.org.
AbstractBACKGROUND:B-cell lymphomas with concurrent translocations of MYC and BCL2 or BCL6, also known as "double-hit" lymphomas (DHL), are rare malignancies characterized by aggressive clinical behavior and poor prognosis. Previous reports suggest that decreased CD20 and/or CD19 expression by flow cytometry is relatively common in DHL and may help to identify cases requiring additional cytogenetic analysis.METHODS:We conducted a retrospective analysis of 26 cases of DHL, and compared their flow cytometric characteristics to cases of Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL). Cases were analyzed by four-color flow cytometry, and bivariate dot-plots were reviewed for light scatter characteristics, CD19, CD20, CD45, and surface light chain.RESULTS:Relatively few DHL cases showed dim expression of CD19 or CD20, and statistically significant differences were found only in the frequency of dim CD19 expression between DHL and BL or DLBCL. Although concomitant dim CD19 and CD20 expression was exclusive to DHL, it was present in only a minority of cases.CONCLUSIONS:We conclude that although a subset of DHL expresses aberrant levels of CD19 and/or CD20 by flow cytometry, these findings are of limited utility in identifying cases requiring cytogenetic analysis due to their low frequency. Until more sensitive pathologic parameters can be identified and validated, the decision to perform cytogenetic analysis should rest on a combination of clinical, morphologic, and immunophenotypic features suggestive of high-grade, aggressive disease. © 2013 International Clinical Cytometry Society.PMID: 23341189

全文链接：http://dx.doi.org/10.1002/cyto.b.21076