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  • Title: Application of modified Matutes score containing CD200 in diagnosis of chronic lymphocytic leukemia.
    Author: Li W, Fang P, Fu G, Liang H, Peng M.
    Journal: Zhong Nan Da Xue Xue Bao Yi Xue Ban; 2022 Dec 28; 47(12):1689-1694. PubMed ID: 36748379.
    Abstract:
    OBJECTIVES: Immunophenotyping technique is a powerful tool for the diagnosis and differential diagnosis of chronic lymphocytic leukemia (CLL) and other B-cell chronic lymphoproliferative diseases (B-CLPD). CD200 is strongly expressed in CLL. This study aims to analyze the clinical value of modified Matutes score (MMS) containing CD200 in the diagnosis of CLL. METHODS: We retrospectively analyzed 103 B-CLPD patients diagnosed from January 2020 to July 2021, including 64 CLL patients, 11 follicular lymphoma (FL) patients, 14 mantle cell lymphoma (MCL) patients, 6 marginal zone lymphoma (MZL) patients, 1 hairy cell leukemia (HCL) patient, and 7 lymphoplasmic lymphoma/Waldenstrom macroglobulinemia (LPL/WM) patients. The expression of CD markers between the CLL group and the non-CLL group was compared, and the sensitivity, specificity, and clinical consistency of MMS and Royal Marsden Hospital (RMH) immunophenotyping score system were analyzed. RESULTS: There were significant differences in the expressions of CD5, CD23, FMC7, CD22, CD79b, CD200, and sIg between the CLL group and the non-CLL group (χ2 values were 37.42, 54.98, 30.71, 11.67, 55.26, 68.48, and 17.88, respectively, all P<0.01). When the RMH immunophenotyping score≥4, the sensitivity was 79.7%, and the specificity was 100%. When the MMS≥3, the sensitivity was 95.3%, and the specificity was 100%. The Kappa coefficient of RMH immunophenotyping system was 0.677, and the Kappa coefficient of MMS system was 0.860. CONCLUSIONS: The MMS system containing CD200 has better sensitivity and same specificity compared with RMH immunophenotyping system, and MMS system may be more useful in the diagnosis of CLL. 目的: 免疫标志分型技术是诊断与鉴别诊断慢性淋巴细胞白血病(chronic lymphocytic leukemia，CLL)及其他B细胞慢性淋巴增殖性疾病(B-cell chronic lymphoproliferative diseases，B-CLPD)的重要手段。CD200在CLL中普遍强表达。本研究旨在分析含有CD200的改良型Matutes免疫标志积分(modified Matutes score，MMS)系统在诊断CLL中的临床应用价值。方法: 回顾性分析2020年1月至2021年7月确诊的103例B-CLPD患者，其中CLL 64例、滤泡性淋巴瘤(follicular lymphoma，FL)11例、套细胞淋巴瘤(mantle cell lymphoma，MCL)14例、边缘区淋巴瘤(marginal zone lymphoma，MZL)6例，毛细胞白血病(hairy cell leukemia，HCL)1例、淋巴浆细胞淋巴瘤/华氏巨球蛋白血症(lymphoplasmic lymphoma/Waldenstrom macroglobulinemia，LPL/WM)7例。比较CLL组及非CLL组CD分子表达的差异，并比较MMS与英国马斯登皇家医院(Royal Marsden Hospital，RMH)免疫标志积分系统在诊断CLL中的敏感性、特异性及与临床的一致性。结果: CLL组及非CLL组在CD5、CD23、FMC7、CD22、CD79b、CD200、sIg表达上差异均有统计学意义(χ2值分别为37.42、54.98、30.71、11.67、55.26、68.48、17.88，均P<0.01)。在诊断CLL上，RMH免疫标志积分≥4时，敏感性79.7%，特异性100%；MMS≥3时，敏感性95.3%，特异性100%。RMH免疫标志积分系统Kappa系数为0.677，MMS系统Kappa系数为0.860。结论: 与RMH免疫标志积分系统比较，含有CD200的MMS系统在诊断CLL上有更好的敏感性、相同的特异性，且与临床有更高的吻合度。. OBJECTIVE: Immunophenotyping technique is a powerful tool for the diagnosis and differential diagnosis of chronic lymphocytic leukemia (CLL) and other B-cell chronic lymphoproliferative diseases (B-CLPD). CD200 is strongly expressed in CLL. This study aims to analyze the clinical value of modified Matutes score (MMS) containing CD200 in the diagnosis of CLL. METHODS: We retrospectively analyzed 103 B-CLPD patients diagnosed from January 2020 to July 2021, including 64 CLL patients, 11 follicular lymphoma (FL) patients, 14 mantle cell lymphoma (MCL) patients, 6 marginal zone lymphoma (MZL) patients, 1 hairy cell leukemia (HCL) patient, and 7 lymphoplasmic lymphoma/Waldenstrom macroglobulinemia (LPL/WM) patients. The expression of CD markers between the CLL group and the non-CLL group was compared, and the sensitivity, specificity, and clinical consistency of MMS and Royal Marsden Hospital (RMH) immunophenotyping score system were analyzed. RESULTS: There were significant differences in the expressions of CD5, CD23, FMC7, CD22, CD79b, CD200, and sIg between the CLL group and the non-CLL group (χ2 values were 37.42, 54.98, 30.71, 11.67, 55.26, 68.48, and 17.88, respectively, all P<0.01). When the RMH immunophenotyping score≥4, the sensitivity was 79.7%, and the specificity was 100%. When the MMS≥3, the sensitivity was 95.3%, and the specificity was 100%. The Kappa coefficient of RMH immunophenotyping system was 0.677, and the Kappa coefficient of MMS system was 0.860. CONCLUSION: The MMS system containing CD200 has better sensitivity and same specificity compared with RMH immunophenotyping system, and MMS system may be more useful in the diagnosis of CLL.
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