Surface immunoglobulin light chain restriction in B-cell non-Hodgkin's malignant lymphomas

American Journal of Clinical Pathology
H Ratech, S Litwin

Abstract

Twenty-four control cases of reactive follicular hyperplasia (RFH) and 28 cases of B-cell non-Hodgkin's malignant lymphoma (ML) were evaluated for surface immunoglobulin (sIg) light chain expression with flow cytometry. Because there was no significant difference between the distribution of the ML kappa/lambda ratios for which kappa/lambda greater than 1 compared with those ML lambda/kappa ratios for which lambda/kappa greater than 1 using the Kolmogorov-Smirnov statistic, the authors treated kappa/lambda and lambda/kappa data symmetrically. By transforming all kappa/lambda ratios to maximum ratios, that is, Rmax = max (kappa/lambda, lambda/kappa), so that all resulting ratios were at least one, the authors defined a new statistic for evaluating sIg light chain restriction. There was a highly significant difference for equality of distribution of the data using the Mann-Whitney test (P less than 0.0001). By choosing cut-points based on the Rmax statistic, the authors were able to separate the RFH and ML cases with sensitivity = 0.96 +/- 0.07 (95% confidence) and with specificity = 0.91 +/- 0.11 (95% confidence). These point estimates of sensitivity and specificity appear to be promising for the clinical utility of the Rmax stat...Continue Reading

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