Wen Jiabing,Li Yong,Xiao Yaling,et al.Value of lymph node biopsy in screening children with lymphoma-associated hemophagocytic syndrome[J].Journal of Clinical Pediatric Surgery,,22():267-271.[doi:10.3760/cma.j.cn101785-202207057-012]
Value of lymph node biopsy in screening children with lymphoma-associated hemophagocytic syndrome
- Abstract:
- Objective To explore the value of lymph node biopsy in screening children with lymphoma-associated hemophagocytic syndrome (HPS).Methods From January 1,2012 to December 31,2021,clinical data were retrospectively reviewed for 513 HPS children and 808 children with lymph node biopsy.They were divided into biopsy and non-biopsy groups while lymphoma-negative children with HLH biopsy were classified as biopsy-negative group and those with a diagnosis of lymphoma lymphoma group.The differences were compared in positive biopsy rate of lymphoma between HLH and non-HLH children.And the differences in gender,age and mortality were compared between biopsy and non-biopsy HLH groups.Also the differences in gender,age,organ imaging abnormalities and lymph node/tissue were compared between HLH biopsy-negative and lymphoma groups.Results A total of 61 lymph node/tissue biopsies were performed in 513 HLH children.Five cases of lymphoma were found and 73 cases of lymphoma detected in 808 children with routine biopsy during the same period.The probability of detecting lymphoma in HLH biopsy was no different from conventional biopsy (χ2=0.049,P=0.825); difference in age existed between biopsy and non-biopsy groups (t=2.024,P=0.043).However,no significant difference existed in gender or mortality (χ2=0.966,P=0.326; χ2=1.432,P=0.233); no difference existed in gender composition between children with negative HLH lymph node biopsy and those with confirmed lymphoma.However,differences existed in age composition,imaging abnormalities and size of biopsy lymph nodes (tissues) (χ2=4.49,P=0.503; t=4.297,P<0.001; χ2=15.486,P<0.001; Z=8.354,P<.001).Conclusion Surgical biopsy in HLH children does not significantly elevate the risk of mortality.However,the positive rate of biopsy is low and biopsy indications should be further refined.There were significant differences in lymph node size and organ imaging abnormalities between HLH children secondary to non-malignant tumors and those with diagnosed lymphoma.It hints that the two may be employed as indicators to further improve lymphoma screening in HLH children.
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Memo
收稿日期:2022-7-29。
基金项目:2020年度湖南省临床医疗技术创新引导项目(2020SK50501)
通讯作者:李勇,Email:liyongpuwaike@163.com