Flow cytometry and cytomorphology evaluation of hematologic malignancy in cerebrospinal fluids: comparison with retrospective clinical outcome

被引：14

作者：

Cesana, Clara ^{[1
,6
]}

Klersy, Catherine ^{[2
]}

Scarpati, Barbara ^{[1
,6
]}

Brando, Bruno ^{[3
,4
]}

Faleri, Maurizio ^{[5
]}

Bertani, Giambattista ^{[1
,6
]}

Gatti, Arianna ^{[3
,4
]}

Volpato, Elisabetta ^{[1
,6
]}

Barba, Claudia ^{[1
,6
]}

Ferri, Ursula ^{[1
,6
]}

Scampini, Linda ^{[1
,6
]}

Grillo, Giovanni ^{[1
,6
]}

Lando, Giuliana ^{[1
,6
]}

Nosari, Annamaria ^{[1
,6
]}

Morra, Enrica ^{[1
,6
]}

Cairoli, Roberto ^{[1
,6
]}

机构：

[1] Osped Niguarda Ca Granda, Dept Transfus Med, I-20162 Milan, Italy

[2] Fdn IRCCS Policlin San Matteo, Serv Biometry & Clin Epidemiol, Pavia, Italy

[3] Legnano Gen Hosp, Ctr Blood, Legnano, Italy

[4] Legnano Gen Hosp, Hematol Lab, Legnano, Italy

[5] Osped Niguarda Ca Granda Hosp, Div Surg Pathol & Cytogenet, Milan, Italy

[6] Osped Niguarda Ca Granda, Div Hematol, I-20162 Milan, Italy

来源：

ANNALS OF HEMATOLOGY | 2011年 / 90卷 / 07期

关键词：

Cerebrospinal fluid; Cytomorphology; Flow cytometry; Hematologic malignancy; Lymphoid neoplasm; OCCULT LEPTOMENINGEAL DISEASE; B-CELL LYMPHOMAS; INTRATHECAL METHOTREXATE; LEUKEMIA; SENSITIVITY; DIAGNOSIS; THERAPY;

D O I：

10.1007/s00277-010-1145-4

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

An independent clinical assessment was compared with flow cytometry (FCM) and cytomorphology results obtained on 227 cerebrospinal fluids investigated for hematologic malignancy, in a retrospective longitudinal study with a median observation time of 11 months. A combined method assessment (CMA), defining "positive" a sample if at least one method gave "positive" results, was also tested. Eleven out of 55 screening samples and 53 out of 166 follow-up samples resulted positive at clinical evaluation. FCM and CM were concordant with positive clinical assessment in 68.5% and 51.5% of cases, respectively. According to CMA, 10.5% of samples (resulting false negative by either FCM or cytomorphology) were rescued as true positive. FCM retained significantly higher accuracy than cytomorphology (p = 0.0065) and 100% sensitivity when at least 220 leukocytes were acquired. CMA accuracy was higher than FCM accuracy and significantly higher than cytomorphology accuracy in the analysis of all samples (p < 0.0001), samples from mature B/T cell neoplasms (p = 0.0021), and samples drawn after intrathecal treatment (p = 0.0001). When acquiring a parts per thousand currency sign220 leukocytes, FCM accuracy was poor, and combining cytomorphology added statistically significant diagnostic advantage (p = 0.0043). Although FCM is the best diagnostic tool for evaluating CSF, morphology seems helpful especially when clinically positive follow-up samples are nearly acellular.

引用

页码：827 / 835

页数：9

共 21 条

[21] Lymphoma, Leukemia, and Pleiocytosis in Cerebrospinal Fluid: Is Accurate Cytopathologic Diagnosis Possible Based on Morphology Alone? [J].

Wu, Julie M. ;

Georgy, Matthew F. ;

Burroughs, Frances H. ;

Weir, Edward G. ;

Rosenthal, Dorothy L. ;

Ali, Syed Z. .

DIAGNOSTIC CYTOPATHOLOGY, 2009, 37 (11) :820-824

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