背景:临床实验室并不常规使用流式细胞术诊断经典霍奇金淋巴瘤(CHL)。
方法:采用10色流式细胞术对14例CHL和132例对照组进行研究。标记包括CD3,CD4,CD7,CD8和CD26,以及计算的参数,如CD4:CD8比率,CD3+CD4+CD26-CD3+CD4+T细胞的百分比,总事件的CD3+CD4+CD26-T细胞百分比,CD3+CD4+CD26-T细胞间的CD7变异系数,和CD3+CD4+CD26-T细胞相对于CD3+CD8+T细胞的CD7中值荧光强度。
结果:CHL病例显示CD3+CD4+T细胞的CD3+CD4+CD26-百分比中位数为72.3%,范围从41.1%到94.4%,总事件中CD3+CD4+CD26-T细胞的中位数百分比为17.4%,范围为4.6%至52.5%,CD3+CD4+CD26-T细胞间CD7变异系数小于100%,和CD3+CD4+CD26-T细胞相对于CD3+CD8+T细胞的CD7中值荧光强度为1.7,范围为0.4至3.5。在对照组中,就这些参数而言,每个实体都与CHL表现出一定程度的重叠。因此构建了“霍奇金评分”以增强CHL与其他实体的分离。15.35的Hodgkin阈值在CHL诊断中的敏感性为78.6%,特异性为96.2%。将Hodgkin评分结合到简单的算法中将特异性提高到100%。
结论:在这项研究中,我们使用流式细胞术证明CHL中CD3+CD4+CD26-T细胞增加,并得出诊断CHL的霍奇金评分。
BACKGROUND: Flow cytometry is not routinely performed in clinical laboratories for the diagnosis of classic Hodgkin lymphoma (CHL).
METHODS: Fourteen cases of CHL and 132 cases of the control group were studied by 10-color flow cytometry, with markers including CD3, CD4, CD7, CD8, and
CD26, as well as calculated parameters such as the CD4:CD8 ratio, percent CD3+CD4+
CD26- T-cells of CD3+CD4+ T-cells, percent CD3+CD4+
CD26- T-cells of total events, CD7 coefficient of variation among CD3+CD4+
CD26- T-cells, and CD7 median fluorescence intensity of CD3+CD4+
CD26- T-cells relative to CD3+CD8+ T-cells.
RESULTS: CHL cases showed a median percent CD3+CD4+
CD26- of CD3+CD4+ T-cells of 72.3% with range from 41.1% to 94.4%, median percent CD3+CD4+CD26- T-cells of total events of 17.4% with range from 4.6% to 52.5%, CD7 coefficient of variation among CD3+CD4+CD26- T-cells less than 100%, and CD7 median fluorescence intensity of CD3+CD4+CD26- T-cells relative to CD3+CD8+ T-cells of 1.7 with range from 0.4 to 3.5. In the control group, every entity showed some degree of overlap with CHL in terms of these parameters. A \"Hodgkin score\" was thus constructed to enhance separation of CHL from other entities. A threshold Hodgkin score of 15.35 achieved a sensitivity of 78.6% and specificity of 96.2% in the diagnosis of CHL. Incorporating the Hodgkin score into a simple algorithm raises the specificity to 100%.
CONCLUSIONS: In this study, we used flow cytometry to demonstrate increased CD3+CD4+CD26- T-cells in CHL, and derived a Hodgkin score for the diagnosis of CHL.