Journal
JOURNAL OF VETERINARY INTERNAL MEDICINE
Volume 34, Issue 2, Pages 669-677Publisher
WILEY
DOI: 10.1111/jvim.15742
Keywords
chronic enteropathy; clonality testing; feline; HGMS; inflammatory bowel disease; inflammatory enteropathy; MALDI mass spectrometry; PARR; PCR for antigen receptor rearrangements; small cell lymphoma
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Funding
- New River VDL, LLC
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Background Differentiation of lymphocytic-plasmacytic enteropathy (LPE) from small cell lymphoma (SCL) in cats can be challenging. Hypothesis/Objective Histology-guided mass spectrometry (HGMS) is a suitable method for the differentiation of LPE from SCL in cats. Animals Forty-one cats with LPE and 52 cats with SCL. Methods This is a retrospective clinicopathologic study. Duodenal tissue samples of 17 cats with LPE and 22 cats with SCL were subjected to HGMS, and the acquired data were used to develop a linear discriminate analysis (LDA) machine learning algorithm. The algorithm was subsequently validated using a separate set of 24 cats with LPE and 30 cats with SCL. Cases were classified as LPE or SCL based on a consensus by an expert panel consisting of 5-7 board-certified veterinary specialists. Histopathology, immunohistochemistry, and clonality testing were available for all cats. The panel consensus classification served as a reference for the calculation of test performance parameters. Results Relative sensitivity, specificity, and accuracy of HGMS were 86.7% (95% confidence interval [CI]: 74.5%-98.8%), 91.7% (95% CI: 80.6%-100%), and 88.9% (95% CI: 80.5%-97.3%), respectively. Comparatively, the clonality testing had a sensitivity, specificity, and accuracy of 85.7% (95% CI: 72.8%-98.7%), 33.3% (95% CI: 14.5%-52.2%), and 61.5% (95% CI: 48.3%-74.8%) relative to the panel decision. Conclusions and Clinical Importance Histology-guided mass spectrometry was a reliable technique for the differentiation of LPE from SCL in duodenal formalin-fixed paraffin-embedded samples of cats and might have advantages over tests currently considered state of the art.
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