A simple clinical scoring system to improve the sensitivity and standardization of the diagnosis of mycosis fungoides type cutaneous T-cell lymphoma: logistic regression of clinical and laboratory data

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dc.contributor.authorStevens, S.R.
dc.contributor.authorKe, M.S.
dc.contributor.authorBirol, A.
dc.contributor.authorTerhune, M.H.
dc.contributor.authorParry, E.J.
dc.contributor.authorRoss, C.
dc.contributor.authorCooper, KD..
dc.date.accessioned2020-06-25T17:35:20Z
dc.date.available2020-06-25T17:35:20Z
dc.date.issued2003
dc.departmentKırıkkale Üniversitesi
dc.descriptionCooper, Kevin/0000-0002-1986-3602
dc.description.abstractBackground The diagnosis of mycosis fungoides (MF) is notoriously difficult to establish because in the early stages, histological features may be nonspecific or merely suggestive. Objectives To standardize the diagnosis of MF. Methods We studied 138 patients with suspected MF referred over a 7-year period to a university department of a dermatology-based cutaneous lymphoma clinic. Six diagnostic criteria were evaluated: clinical morphology, clinical distribution, skin biopsy T-cell receptor gene rearrangement (TCR-GR), skin biopsy pan T-cell marker loss greater than or equal to 2, skin biopsy CD4/CD8 ratio greater than or equal to 6, and skin biopsy diffuse epidermal HLA-DR expression. These six clinical and laboratory criteria were compared by logistic regression analysis in patients with histologically diagnosed MF and those with benign disease. Results Of the 138 patients, 74 had histology of MF, 47 of benign dermatoses and 17 were indeterminate. Close associations were found between a histological diagnosis of MF and TCR-GR (odds ratio 14.4), classical morphology (7.5), classical distribution (2.5) and diffuse epidermal HLA-DR expression (2.8). Logistic regression models were developed depending on the availability of data (either TCR-GR or HLA-DR). Probabilities for correctly diagnosing MF compared with histology as the 'gold standard' were derived from these logistic regression models. A scoring system assigning point values based on these probabilities was then created in order to assist the clinician in making the diagnosis. If using TCR-GR data, a positive TCR-GR = 2.5 points, the presence of classical morphology = 2.0 points, and the presence of classical distribution = 1.5 points. A total score of greater than or equal to 3.5 points assigns a high probability (> 85%) of having MF. If using HLA-DR expression, then the presence of classical morphology = 2.5 points, a positive diffuse epidermal HLA-DR expression = 2.0 points, and the presence of classical distribution = 1.5 points. In this case, a total score of greater than or equal to 4.0 points assigns a high probability (> 85%) of MF. Conclusions The logistic regression models and scoring systems integrate clinical and laboratory assessments, allow rapid probability estimation, and provide a threshold for the diagnosis of MF in an objective, standardized manner.en_US
dc.description.sponsorshipNIAMS NIH HHSUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) [1K08 AR02063, 5P30 AR39750]en_US
dc.identifier.citationclosedAccessen_US
dc.identifier.doi10.1046/j.1365-2133.2003.05458.x
dc.identifier.endpage522en_US
dc.identifier.issn0007-0963
dc.identifier.issue3en_US
dc.identifier.pmid14510983
dc.identifier.scopus2-s2.0-0142088940
dc.identifier.scopusqualityQ1
dc.identifier.startpage513en_US
dc.identifier.urihttps://doi.org/10.1046/j.1365-2133.2003.05458.x
dc.identifier.urihttps://hdl.handle.net/20.500.12587/3092
dc.identifier.volume149en_US
dc.identifier.wosWOS:000185534600011
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherBlackwell Publishing Ltden_US
dc.relation.ispartofBritish Journal Of Dermatology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectdiagnosisen_US
dc.subjectmycosis fungoidesen_US
dc.titleA simple clinical scoring system to improve the sensitivity and standardization of the diagnosis of mycosis fungoides type cutaneous T-cell lymphoma: logistic regression of clinical and laboratory dataen_US
dc.typeArticle

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