Integrating flow cytometric profile and gene mutation analysis of intact lymph nodes to refine lymphoma

Qun-Yi Peng1, Hong-Yuan Chen1, Yan Zheng1

  • 1Department of Hematology, Quanzhou First Hospital of Affiliated to Fujian Medical University Quanzhou 362000, Fujian, China.

Insights

Integrating multi-parameter flow cytometry (FCM) with gene mutation analysis improves lymphoma classification. This combined approach enhances diagnostic accuracy for B-cell and T/NK-cell lymphomas using intact lymph node samples.

Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • Accurate lymphoma classification is crucial for effective treatment.
  • Traditional diagnostic methods can be limited in differentiating certain lymphoma subtypes.
  • Multi-parameter flow cytometry (FCM) and gene mutation analysis offer complementary diagnostic information.

Purpose of the Study:

  • To evaluate the combined diagnostic utility of FCM, histopathology, and gene mutation analysis for lymphoma classification.
  • To assess the concordance between FCM and histopathology in diagnosing lymphoma.
  • To explore the role of specific gene mutations and associated protein expression in refining lymphoma diagnosis.

Main Methods:

  • Retrospective analysis of 109 intact lymph node (LN) samples from patients with lymphadenopathy.
  • Utilized multi-color FCM, histopathology, and next-generation sequencing (NGS) targeting 62 lymphoma-related genes.
  • Correlated FCM immunophenotyping and mutation profiles with pathological diagnoses.

Main Results:

  • FCM demonstrated high concordance with histopathology in lymphoma detection.
  • Distinct cell size (FSC) profiles and PD-1 expression on T cells differentiated lymphoma subtypes.
  • Specific gene mutations (e.g., IGHV, BCL2, EZH2, BCL6) were identified in different lymphoma subtypes.
  • Mutation-guided FCM confirmed protein expression, aiding in diagnosis.
  • T/NK-cell lymphomas exhibited aberrant antigen expression and restricted TRBC1 clonality.

Conclusions:

  • FCM on intact LNs is a reliable diagnostic tool with strong pathologic concordance.
  • Integrating gene mutation data with FCM provides a powerful, multi-parameter diagnostic strategy.
  • This integrated approach refines lymphoma classification beyond standard immunophenotyping, enhancing diagnostic accuracy.
Abstract

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