病理医师很难对粘膜相关淋巴组织(MALT淋巴瘤)的结外边缘区淋巴瘤进行组织学诊断。最近,数字病理系统已被广泛用于提供可以客观地测量载玻片上的病变的工具。在这项研究中,我们测量了疑似MALT淋巴瘤病例中边缘区扩张的程度,并将结果与分子克隆性试验的结果进行了比较.总的来说,本研究包括115例因疑似MALT淋巴瘤而接受IGH基因重排测试的患者。所有病例在组织学上分为三种模式:“无生发中心的小淋巴聚集物(模式1),“淋巴滤泡有生发中心(模式2)”和“融合边缘区或弥漫性小淋巴细胞增生(模式3)。“模式1、2和3中单克隆性的比例为25.0%,55.0%,和97.9%,分别。使用数字病理系统在模式2例中测量了边缘区厚度与生发中心直径的比率以及整个淋巴滤泡面积与生发中心面积的比率。结合1.5的宽度截止和3.5的面积截止,灵敏度,特异性,正预测值,MALT淋巴瘤的阴性预测值为96.97%,70.37%,80.00%,和95.00%,分别。总之,通过对边缘区域的客观测量,可以有效选择需要分子克隆性测试的MALT淋巴瘤疑似病例。
The histological diagnosis of extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is difficult for pathologists. Recently, digital pathology systems have been widely used to provide tools that can objectively measure lesions on slides. In this study, we measured the extent of marginal zone expansion in suspected MALT lymphoma cases and compared the results with those of a molecular clonality test. In total, 115 patients who underwent an IGH gene rearrangement test for suspected MALT lymphoma were included in this study. All cases were histologically classified into three patterns; \"small lymphoid aggregates with no germinal center (Pattern 1),\" \"lymphoid follicles with germinal center (Pattern 2)\" and \" fused marginal zone or diffuse small lymphocytic proliferation (Pattern 3).\" The proportions of monoclonality in Pattern 1, 2, and 3 were 25.0%, 55.0%, and 97.9%, respectively. The ratios of marginal zone thickness to germinal center diameter and entire lymphoid follicle area to germinal center area were measured in Pattern 2 cases using a digital pathology system. Combining the width cutoff of 1.5 and the areal cutoff of 3.5, the sensitivity, specificity, positive predictive value, and negative predictive value for MALT lymphoma were 96.97%, 70.37%, 80.00%, and 95.00%, respectively. In conclusion, through objective measurement of the marginal zone, suspected cases of MALT lymphoma requiring a molecular clonality test can be effectively selected.