Application of the current diagnostic algorithm for early mycosis fungoides to a single center cohort: Identification of challenges and suggestions for modification
Application of the current diagnostic algorithm for early mycosis fungoides to a single center cohort: Identification of challenges and suggestions for modification
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DOI：
10.1111/cup.14243
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发表时间：
2022-06-06
影响因子：
1.7
通讯作者：
Nikbakht, Neda
中科院分区：
文献类型：
--
作者：
Krishnasamy, Shalini;Correia, Emily;Nikbakht, Neda
背景诊断早期蕈样肉芽肿（MF）仍然是一个重大的挑战。国际皮肤淋巴瘤学会（ISCL）提出了一种结合临床和组织病理学特征以及免疫组织化学和分子研究诊断早期MF的算法。在这里，我们的目标是检查的ISCL算法的诊断效用。方法采用单中心回顾性研究方法，对28例确诊为早期MF的患者应用ISCL算法进行分析。未对所有患者进行免疫组织化学和分子研究，因此进行了亚组分析，包括18例进行了两项研究的患者。我们计算了算法的诊断灵敏度。随后，我们研究了如何修改算法的组织病理学标准从epidermotropism没有海绵状变性epidermotropism影响其灵敏度。结果43%（12/28）的队列和50%（9/18）的亚组符合算法的诊断阈值。当修改算法时，71%的队列和89%的亚组达到了算法的阈值。结论虽然ISCL算法在诊断早期MF中是有用的，但其灵敏度仍不理想。进一步改进算法以捕获MF的海绵体亚型可能会提高其诊断价值。
Background Diagnosing early-stage mycosis fungoides (MF) remains a significant challenge. The International Society for Cutaneous Lymphomas (ISCL) proposed an algorithm for diagnosing early MF incorporating clinical and histopathologic characteristics, as well as immunohistochemistry and molecular studies. Here we aim to examine the diagnostic utility of the ISCL algorithm. Methods In this single-center retrospective review, the ISCL algorithm was applied to 28 patients diagnosed with early-stage MF. Immunohistochemistry and molecular studies were not performed for all patients, so a subgroup analysis was conducted including 18 patients in whom both studies had been performed. We calculated the diagnostic sensitivity of the algorithm. Subsequently, we examined how modifying the algorithm's histopathologic criterion from epidermotropism without spongiosis to epidermotropism influenced its sensitivity. Results Forty-three percent (12/28) of the cohort and 50% (9/18) of the subgroup met the algorithm's diagnostic threshold. When the algorithm was modified, 71% of the cohort and 89% of the subgroup met the algorithm's threshold. Conclusion While the ISCL algorithm is useful in diagnosing early-stage MF, its sensitivity remains suboptimal. Further refinement of the algorithm to capture spongiotic subtypes of MF may improve its diagnostic value.