7 research outputs found
The predictive significance of CD20 expression in B-cell lymphomas
<p>Abstract</p> <p>Background</p> <p>In our recent study, we determined the cut-off value of CD20 expression at the level of 25 000 molecules of equivalent soluble fluorochrome (MESF) to be the predictor of response to rituximab containing treatment in patients with B-cell lymphomas. In 17.5% of patients, who had the level of CD20 expression below the cut-off value, the response to rituximab containing treatment was significantly worse than in the rest of the patients with the level of CD20 expression above the cut-off value. The proportion of patients with low CD20 expression who might not benefit from rituximab containing treatment was not necessarily representative. Therefore the aim of this study was to quantify the CD20 expression in a larger series of patients with B-cell lymphomas which might allow us to determine more reliably the proportion of patients with the CD20 expression below the cut-off.</p> <p>Methods</p> <p>Cytological samples of 64 diffuse large B-cell lymphomas (DLBCL), 56 follicular lymphomas (FL), 31 chronic lymphocytic leukemias (CLL), 34 mantle cell lymphomas (MCL), 18 marginal zone lymphomas (MZL) and 15 B-cell lymphomas unclassified were analyzed for CD20 expression by quantitative four-color flow cytometric measurements using FACSCalibur flow cytometer (BD Biosciences).</p> <p>Results</p> <p>The range of CD20 expression in different B-cell lymphomas was very broad, varying from 2 737 to 115 623 MESF in CLL and 3 549 to 679 577 MESF in DLBCL. However, when we compared the CD20 expression in the groups of patients with DLBCL, FL, MCL, MZL, CLL and B-cell lymphomas unclassified, it was found to be significantly lower (p = 0.002) only in CLL but did not significantly differ in other lymphoma types (p = NS). Fifty-three out of 218 (24.3%) patients with B-cell lymphomas had the CD20 expression below the cut-off value.</p> <p>Conclusions</p> <p>The CD20 expression in CLL is significantly lower than in most histological types of mature B-cell lymphomas in which it appears to be comparable. Approximately 25% of B-cell lymphoma patients have the CD20 expression below the cut-off value showing that the low CD20 expression might be more common than presumed from our previous study.</p
Survey of medical training in cytopathology carried out by the journal Cytopathology
This report of the Editorial Advisory Board of Cytopathology gives the
results of a survey of medical practitioners in cytopathology, which
aimed to find out their views on the current situation in undergraduate
and postgraduate training in their institutions and countries. The
results show that training in cytopathology and histopathology are
largely carried out at postgraduate level and tend to be organized
nationally rather than locally. Histopathology was regarded as essential
for training in cytopathology by 89.5% of respondents and was mandatory
according to 83.1%. Mandatory cytopathology sections of histopathology
were reported by 67.3% and specific examinations in cytopathology by
55.4%. The main deficiencies in training were due to its variability;
there were insufficient numbers of pathologists interested in cytology
and a consequent lack of training to a high level of competence.
Pathologists without specific training in cytopathology signed out
cytology reports according to 54.7% of responses, more often in centres
where training was 3-6 months or less duration. Although 92.2% of
respondents thought that specialist cytology should not be reported by
pathologists without experience in general cytopathology, that practice
was reported by 30.9%, more often in centres with small workloads. The
survey report recommends that 6-12 months should be dedicated to
cytopathology during histopathology training, with optional additional
training for those wanting to carry out independent practice in
cytopathology. Formal accreditation should be mandatory for independent
practice in cytopathology. When necessary, temporary placements to
centres of good practice should be available for trainees intending to
practise independently in cytopathology. There should be adequate
numbers of pathologists trained in cytopathology to a high level of
competence; some of their time could be released by training
cytotechnologists and trainee pathologists to prescreen cytology slides
and assess adequacy of fine-needle aspiration samples when immediate
diagnosis was not required. The survey demonstrated a clear need for
European and international guidelines for training in cytopathology