Endoscopic Ultrasound-Guided Fine Needle Aspiration Biopsy for Diagnosis of Lymphoproliferative Disorders: Feasibility of Immunohistological, Flow Cytometric, and Cytogenetic Assessments
Endoscopic Ultrasound-Guided Fine Needle Aspiration Biopsy for Diagnosis of Lymphoproliferative Disorders: Feasibility of Immunohistological, Flow Cytometric, and Cytogenetic Assessments
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DOI：
10.1038/ajg.2011.350
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发表时间：
2012-03-01
影响因子：
9.8
通讯作者：
Moriwaki, Hisataka
中科院分区：
文献类型：
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作者：
Yasuda, Ichiro;Goto, Naoe;Moriwaki, Hisataka
目的：除了形态学之外，在淋巴增殖性疾病的诊断和亚分类过程中还应评估免疫表型和遗传异常。本研究的目的是评估使用标准 19 号针进行超声内镜引导细针抽吸活检 (EUS-FNAB) 进行淋巴瘤诊断和分类的效果，评估免疫组织学、流式细胞术和细胞遗传学评估的可行性。 方法：2005 年 6 月至 12 月期间，240 名疑似淋巴瘤患者被转诊至我们的四级 EUS 中心进行 EUS-FNAB 2010年。尝试对所有患者使用传统的19号针进行EUS-FNAB，然后进行组织学评估，包括免疫组织学染色、流式细胞术和细胞遗传学分析（G带核型分析）。在这些患者中，有152人最终被诊断出患有淋巴瘤。本研究的主要结果指标是组织学评估（包括免疫组织学染色、流式细胞术和 G 带核型分析）对淋巴瘤诊断和亚分类的敏感性。 结果：最终诊断为淋巴瘤的 152 例患者中，147 例（96.7%）通过 EUS-FNAB 诊断，135 例（88.8%）患者也可以根据 WHO（世界卫生组织）系统进行分类。组织学结果的基础，包括免疫组织学染色。流式细胞术显示，152 名淋巴瘤患者中有 121 名 (79.6%) 存在异常或异常细胞群，126 名 B 细胞淋巴瘤患者中有 114 名 (90.5%) 存在异常细胞群。 21 例（13.8%）淋巴瘤患者检测到特异性细胞遗传学异常。结论：使用标准 19 号针的 EUS-FNAB 对淋巴瘤具有较高的诊断价值。免疫表型分析通常是可能的，而细胞遗传学异常可以在相对有限的患者中被识别。
OBJECTIVES: In addition to morphology, immunophenotype and genetic abnormalities should be assessed during diagnosis and subclassification of lymphoproliferative disorders. The objective of this study was to evaluate the yield of endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) using a standard 19-gauge needle for diagnosis and subclassification of lymphoma, assessing the feasibility of immunohistological, flow cytometric, and cytogenetic assessments.METHODS: Two hundred forty patients with suspected lymphoma were referred for EUS-FNAB to our quaternary EUS center between June 2005 and December 2010. EUS-FNAB using a conventional 19-gauge needle was attempted for all patients, followed by histological assessments including immunohistological staining, flow cytometry, and cytogenetic analysis (G-band karyotyping). Among the patients, 152 were ultimately diagnosed with lymphoma. The primary outcome measure of this study was the sensitivity of histological assessment, including immunohistological staining, flow cytometry, and G-band karyotyping, for diagnosis and subclassification of lymphoma.RESULTS: Among the 152 patients ultimately diagnosed with lymphoma, 147 patients (96.7%) were diagnosed by EUS-FNAB, and classification in accordance with the WHO (World Health Organization) system was also possible for 135 patients (88.8%) on the basis of histological findings, including immunohistological staining. Flow cytometry showed abnormal or unusual cell populations in 121 (79.6%) of the 152 patients diagnosed with lymphoma, and in 114 (90.5%) of the 126 patients diagnosed with B-cell lymphoma. Specific cytogenetic abnormalities were detected in 21 (13.8%) of the lymphoma patients.CONCLUSIONS: EUS-FNAB using a standard 19-gauge needle has high diagnostic value for lymphoma. Immunophenotyping is usually possible, while cytogenetic abnormalities can be identified in a relatively limited number of patients.