https://scholars.lib.ntu.edu.tw/handle/123456789/639658
標題: | CXCL9 as a Reliable Biomarker for Discriminating Anti-IFN-γ-Autoantibody-Associated Lymphadenopathy that Mimics Lymphoma | 作者: | CHANG-TSU YUAN Huang, Wan-Ting Hsu, Chia-Lang Wang, Hsuan Pan, Yi-Hua UN-IN WU JANN-TAY WANG WANG-HUEI SHENG YEE-CHUN CHEN SHAN-CHWEN CHANG |
關鍵字: | CXCL9; IgG4-related lymphadenopathy; adult-onset immunodeficiency; angioimmunoblastic T-cell lymphoma; disseminated nontuberculous mycobacterial infection; multicentric Castleman disease; neutralizing anti-interferon-gamma autoantibody | 公開日期: | 28-一月-2024 | 卷: | 44 | 期: | 1 | 來源出版物: | Journal of clinical immunology | 摘要: | The diagnosis of adult-onset immunodeficiency syndrome associated with neutralizing anti-interferon γ autoantibodies (AIGA) presents substantial challenges to clinicians and pathologists due to its nonspecific clinical presentation, absence of routine laboratory tests, and resemblance to certain lymphoma types, notably nodal T follicular helper cell lymphoma, angioimmunoblastic type (nTFHL-AI). Some patients undergo lymphadenectomy for histopathological examination to rule out lymphoma, even in the absence of a preceding clinical suspicion of AIGA. This study aimed to identify reliable methods to prevent misdiagnosis of AIGA in this scenario through a retrospective case-control analysis of clinical and pathological data, along with immune gene transcriptomes using the NanoString nCounter platform, to compare AIGA and nTFHL-AI. The investigation revealed a downregulation of the C-X-C motif chemokine ligand 9 (CXCL9) gene in AIGA, prompting an exploration of its diagnostic utility. Immunohistochemistry (IHC) targeting CXCL9 was performed on lymph node specimens to assess its potential as a diagnostic biomarker. The findings exhibited a significantly lower density of CXCL9-positive cells in AIGA compared to nTFHL-AI, displaying a high diagnostic accuracy of 92.3% sensitivity and 100% specificity. Furthermore, CXCL9 IHC demonstrated its ability to differentiate AIGA from various lymphomas sharing similar characteristics. In conclusion, CXCL9 IHC emerges as a robust biomarker for differentiating AIGA from nTFHL-AI and other similar conditions. This reliable diagnostic approach holds the potential to avert misdiagnosis of AIGA as lymphoma, providing timely and accurate diagnosis. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/639658 | ISSN: | 02719142 | DOI: | 10.1007/s10875-023-01643-z |
顯示於: | 醫學系 |
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