Value of Multi-Parameter Flow Cytometry Immunophenotyping in T/NK-cell Neoplasms in cytology specimens: a Retrospective Study in Chinese

Abstract Background Innate limitations of morphological diagnosis of T/NK-cell neoplasms mean they can be misdiagnosed or missed, especially when mixed with a variety of benign and reactive conditions. The aim of this study was to investigate the application value of multiparameter flow cytometry immunophenotyping (MFCI) in screening and diagnosing T/NK-cell neoplasms with cytology specimens. Material and methods The clinical and pathological characteristics of 1028 newly diagnosed cases from Fudan University Shanghai Cancer Center who provided a cytology specimen between June 2010 and January 2016 with correlated histology diagnosis and clinical confirmation were retrospectively reviewed. MFCI was used for screening, diagnosis and typing. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in diagnosis of T/NK-cell neoplasms were calculated. Results A total of 146 suspected T/NK-cell neoplasms were screened out (sensitivity = 94.64%, specificity = 95.63% PPV = 72.60%, NPV = 99.32%) by MFCI, with 112 (76.71%) histologically confirmed cases and 6 (4.11%) false-negative cases identified (3 cases diagnosed as B-cell neoplasms and 1 case as T-cell neoplasm with B-cell neoplasm, which also were confirmed by gene rearrangement. 2 cases were suspicious T-cell–immunophenotypic abnormalities). When used at the diagnostic level, a total of 88 T/NK-cell neoplasms were identified (sensitivity = 68.75%, specificity = 98.80%, PPV = 87.50%, NPV = 96.28%) with 11 false-positive cases recognized, 9 of which showed typical immunophenotypic T-cell neoplasms features, and 2 exhibited aberrant T immunophenotype. Conclusions MFCI has high sensitivity and specificity in the screening and diagnosis of T/NK-cell neoplasms and may be useful as an alternative diagnosis method in cytology specimens.