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Lymphoma is a type of malignant tumor with extremely complicated pathological types and clinical manifestations, and many difficult cases
.
In recent years, the diagnosis, staging, treatment and curative effect judgments of lymphoma have become more and more refined, and pathological diagnosis has played an important role in promoting the refinement of lymphoma diagnosis and treatment
.
From July 3 to 4, 2021, the 3rd Hematological Tumor Accurate Detection Summit Forum was successfully held in Beijing
.
During this period, Yimaitong specially invited Professor Shi Yunfei from Peking University Cancer Hospital to share the current status of lymphoma diagnosis and treatment in China and the new progress in pathological diagnosis
.
The diagnosis and treatment of lymphoma is booming, and the pathology department assists in the complicated pathological classification of lymphoma.
According to the Classification and Standards of Hematopoietic and Lymphoid Tissue Tumors issued by the World Health Organization in 2017, malignant tumors of the lymphoid hematopoietic system are divided into more than 170 types
.
Professor Shi Yunfei pointed out that the classification standard combines morphology, immunophenotype, molecular genetics, and molecular mutations detected by new second-generation sequencing methods.
It is currently a more advanced classification standard and an important basis for clinical guidance.
Greatly improve the diagnosis and prognosis of patients
.
Although there are advanced classification standards, the biological behavior and treatment options of lymphoma vary greatly.
Especially for difficult cases, the cooperation of multidisciplinary teams is required to provide patients with accurate diagnosis and individualized treatment plans
.
In such a professional multidisciplinary diagnosis and treatment team, the pathology department is at the core
.
Professor Shi Yunfei pointed out that in the early screening of patients with relapsed and refractory lymphoma, new molecular biology technologies, including the comprehensive application of next-generation sequencing and fluorescence in situ hybridization (FISH), have enriched tumor biomarkers.
The detection method can effectively guide disease diagnosis and prognosis assessment, thereby improving the survival benefit of patients with relapse and refractory treatment
.
In this regard, Professor Yunfei Shi shared a case of a 40-year-old male patient who was diagnosed as early vascular immunoblast T-cell lymph through gene rearrangement and second-generation sequencing when the diagnosis results of multiple hospitals were different.
Based on this, a suitable treatment plan has been developed for the patient, so that the patient can obtain a good curative effect
.
Introducing pathological techniques to meet the arrival of the era of precision.
Pathological examination is the main method of lymphoma diagnosis.
It requires comprehensive application of morphology, immunohistochemistry, genetics and molecular biotechnology, as well as flow cytometry
.
Among them, immunohistochemistry can be used to identify the immunophenotype of lymphoma cells, and to determine the cell source (such as B or T/NK cells), differentiation, and maturity of the disease based on this
.
Further, through the combination of relevant immunohistochemical markers, the differential diagnosis of different pathological subtypes; FISH detection technology can find specific chromosome breaks, translocations or amplifications, etc.
, which has guiding significance for the auxiliary diagnosis of specific chromosomal abnormalities related lymphomas; Lymphocyte antigen receptor gene rearrangement detection technology can be used to help identify the proliferation properties of lymphocytes (monoclonal and polyclonal), and lymphomas that cannot be diagnosed by immunohistochemistry.
It is for morphological and immunohistochemical examinations.
Important supplement
.
Other detection techniques include second-generation sequencing, flow cytometry, etc.
, all of which are beneficial auxiliary methods for routine pathological diagnosis methods
.
Regarding the new technology of pathological diagnosis, Professor Yunfei Shi concluded that the technology of molecular biology makes the diagnosis of lymphoma more precise, helps the classification of the disease, promotes the renewal of the concept of pathological diagnosis, and at the same time clarifies the pathogenesis.
It also has a promoting effect in guiding targeted therapy
.
The renewal of technology also puts forward new requirements for diseased tissue specimens
.
Professor Shi Yunfei believes that in order to ensure the heterogeneity of lymphoma morphology and tissue structure, the diseased tissue specimen obtained by surgical biopsy should be preferred; if it is not available, the tissue strip can be obtained by hollow needle puncture, and after the tissue is isolated Fixed with formalin within half an hour
.
Summary In the era of precision lymphoma treatment, pathological examination is the only way to diagnose lymphoma.
Pathologists are the core members of the lymphoma multidisciplinary diagnosis and treatment team
.
Driven by the continuous updating of pathological examination technology, the diagnosis and treatment of lymphoma must be full of hope in the future, bringing more benefits to patients with lymphoma
.
Professor Yunfei Shi Associate Chief Physician of the Department of Pathology, Peking University Cancer Hospital, Deputy Director of the Department of Pathology, Xinjiang Medical University Affiliated Traditional Chinese Medicine Hospital (on post), visited the National Cancer Center of the City of Hope in the United States, CSCO Anti-Leukemia and Lymphoma Alliance Youth Committee Member, Chinese Anti-Cancer Association Member of the Lymphoma Group of the Pathology Professional Committee Member of the Lymphoma Hematology Committee of the Beijing Anti-Cancer Association Member of the Lymphoma Group of the Pathology Branch of the Beijing Medical Association has been engaged in pathology for more than 10 years, is good at pathological diagnosis of common tumors, and focuses on pathological diagnosis and scientific research of lymphoma.
" Read the original ", we make progress together
.
In recent years, the diagnosis, staging, treatment and curative effect judgments of lymphoma have become more and more refined, and pathological diagnosis has played an important role in promoting the refinement of lymphoma diagnosis and treatment
.
From July 3 to 4, 2021, the 3rd Hematological Tumor Accurate Detection Summit Forum was successfully held in Beijing
.
During this period, Yimaitong specially invited Professor Shi Yunfei from Peking University Cancer Hospital to share the current status of lymphoma diagnosis and treatment in China and the new progress in pathological diagnosis
.
The diagnosis and treatment of lymphoma is booming, and the pathology department assists in the complicated pathological classification of lymphoma.
According to the Classification and Standards of Hematopoietic and Lymphoid Tissue Tumors issued by the World Health Organization in 2017, malignant tumors of the lymphoid hematopoietic system are divided into more than 170 types
.
Professor Shi Yunfei pointed out that the classification standard combines morphology, immunophenotype, molecular genetics, and molecular mutations detected by new second-generation sequencing methods.
It is currently a more advanced classification standard and an important basis for clinical guidance.
Greatly improve the diagnosis and prognosis of patients
.
Although there are advanced classification standards, the biological behavior and treatment options of lymphoma vary greatly.
Especially for difficult cases, the cooperation of multidisciplinary teams is required to provide patients with accurate diagnosis and individualized treatment plans
.
In such a professional multidisciplinary diagnosis and treatment team, the pathology department is at the core
.
Professor Shi Yunfei pointed out that in the early screening of patients with relapsed and refractory lymphoma, new molecular biology technologies, including the comprehensive application of next-generation sequencing and fluorescence in situ hybridization (FISH), have enriched tumor biomarkers.
The detection method can effectively guide disease diagnosis and prognosis assessment, thereby improving the survival benefit of patients with relapse and refractory treatment
.
In this regard, Professor Yunfei Shi shared a case of a 40-year-old male patient who was diagnosed as early vascular immunoblast T-cell lymph through gene rearrangement and second-generation sequencing when the diagnosis results of multiple hospitals were different.
Based on this, a suitable treatment plan has been developed for the patient, so that the patient can obtain a good curative effect
.
Introducing pathological techniques to meet the arrival of the era of precision.
Pathological examination is the main method of lymphoma diagnosis.
It requires comprehensive application of morphology, immunohistochemistry, genetics and molecular biotechnology, as well as flow cytometry
.
Among them, immunohistochemistry can be used to identify the immunophenotype of lymphoma cells, and to determine the cell source (such as B or T/NK cells), differentiation, and maturity of the disease based on this
.
Further, through the combination of relevant immunohistochemical markers, the differential diagnosis of different pathological subtypes; FISH detection technology can find specific chromosome breaks, translocations or amplifications, etc.
, which has guiding significance for the auxiliary diagnosis of specific chromosomal abnormalities related lymphomas; Lymphocyte antigen receptor gene rearrangement detection technology can be used to help identify the proliferation properties of lymphocytes (monoclonal and polyclonal), and lymphomas that cannot be diagnosed by immunohistochemistry.
It is for morphological and immunohistochemical examinations.
Important supplement
.
Other detection techniques include second-generation sequencing, flow cytometry, etc.
, all of which are beneficial auxiliary methods for routine pathological diagnosis methods
.
Regarding the new technology of pathological diagnosis, Professor Yunfei Shi concluded that the technology of molecular biology makes the diagnosis of lymphoma more precise, helps the classification of the disease, promotes the renewal of the concept of pathological diagnosis, and at the same time clarifies the pathogenesis.
It also has a promoting effect in guiding targeted therapy
.
The renewal of technology also puts forward new requirements for diseased tissue specimens
.
Professor Shi Yunfei believes that in order to ensure the heterogeneity of lymphoma morphology and tissue structure, the diseased tissue specimen obtained by surgical biopsy should be preferred; if it is not available, the tissue strip can be obtained by hollow needle puncture, and after the tissue is isolated Fixed with formalin within half an hour
.
Summary In the era of precision lymphoma treatment, pathological examination is the only way to diagnose lymphoma.
Pathologists are the core members of the lymphoma multidisciplinary diagnosis and treatment team
.
Driven by the continuous updating of pathological examination technology, the diagnosis and treatment of lymphoma must be full of hope in the future, bringing more benefits to patients with lymphoma
.
Professor Yunfei Shi Associate Chief Physician of the Department of Pathology, Peking University Cancer Hospital, Deputy Director of the Department of Pathology, Xinjiang Medical University Affiliated Traditional Chinese Medicine Hospital (on post), visited the National Cancer Center of the City of Hope in the United States, CSCO Anti-Leukemia and Lymphoma Alliance Youth Committee Member, Chinese Anti-Cancer Association Member of the Lymphoma Group of the Pathology Professional Committee Member of the Lymphoma Hematology Committee of the Beijing Anti-Cancer Association Member of the Lymphoma Group of the Pathology Branch of the Beijing Medical Association has been engaged in pathology for more than 10 years, is good at pathological diagnosis of common tumors, and focuses on pathological diagnosis and scientific research of lymphoma.
" Read the original ", we make progress together
