tbuckley/cabot-search huggingface dataset:
Peripheral immunological response to treatment with checkpoint inhibitor in recurrent/metastatic nasopharyngeal carcinoma.
Authors: Dora Lai Wan Kwong, Ngar-Woon Kam, Ho-Yin Luk, Tae Yang Desmond Hung, Man Kim Yim, Victor Ho-Fun Lee
Journal: Journal of Clinical Oncology (2020)

e18519 Background: A better understanding of peripheral cellular phenotypes in association with checkpoint inhibitors (CPI) responsiveness in recurrent/metastatic NPC could profoundly impact our knowledge of NPC immunopathology. Methods: Blood were collected from 11 patients with recurrent/metastatic NPC who received CPI (pembrolizumab) after failing second-line chemotherapy. Response to pembrolizumab was assessed by imaging and EBV DNA. Patients who achieved CR/PR were considered responsive and those with SD/PD were considered non-responsive. Four patients in the responsive group also had baseline blood before pembrolizumab. PBMC were freshly isolated and stored until analysis. For surface staining, cells were rested overnight at 37°C before resuspended in BD Brilliant stain with 2.5ng/µl Fc block for 15mins. Cells were then co-stained: 7-AAD, CD19-BV510, CD3-Alexa Fluo 700, CD4-BV510, CD279(PD-1)-BB515, CD197(CCR7)-BV421, CD45RO-APC, CD45RA-Pe-Cy5, CD8-APC-H7, CD27-PE, CD95-PE-Cy7, incubated on ice for 30mins. Samples were washed and acquired on NovoCyte Quanteon. Immune phenotypes were correlated with clinical response. Results: We found that: 1) %CD3 was upregulated in responsive group; 2) CD4/CD8 ratio did not directly stratify drug responsiveness; 3) frequency of PD1-expressing CD8+ T cells was significantly reduced in responsive group; 4) lower frequency of CCR7+PD1+CD8+ T cells in responsive group, suggesting that these may be highly differentiated and have the ability to move into peripheral sites in response to inflammatory chemokines; 5) frequency of naïve and TEMRA CD8+ T cells, but not Tscm was upregulated in responsive group; 6) finally, an interesting finding of sustained CD19+ subsets was observed in non-responsive group. Conclusions: Our results suggest that peripheral blood analysis may provide valuable insights into NPC patients’ responses to PD-1-targeted therapies. [Table: see text]
Multicenter analysis of serum tumor markers, treatment patterns, and relapse in patients with testicular cancer in clinical stage IS.
Authors: Maximilian Peter Johannes Karl Brandt, Christian Guido Ruf, Klaus Peter Dieckmann, Isabella Syring, Christian Ruckes, Andreas Hiester, Peter Albers, Bolenz Christian, Axel Heidenreich, Axel Haferkamp, Friedemann Zengerling, Pia Paffenholz
Journal: Journal of Clinical Oncology (2020)

5052 Background: Testicular germ cell tumors (TGCT) in clinical stage I (CSI) are tumors confined to the testis without evidence of metastasis. Around 50% of all TGCT patients present with elevated serum tumor markers (TM) such as alpha-feto protein (AFP), beta-humanochoriongonadotropin (ß-HCG) and lactate-dehydrogenase (LDH). After ablatio testis, TMs usually return to normal according to half-life kinetics, however, in clinical stage IS (CSIS) TMs remain elevated or increase after surgery. Follow-up data on CSIS is scarce and our study aims to assess clinical characteristics and oncologic outcomes in a large TGCT cohort. Methods: In this multicenter study we collected data from 5 tertiary referring hospitals in Germany, included patients with CSIS and evaluated TM levels, treatment and the primary outcome relapse-free survival. False CSIS was defined as documented CSIS but TMs that returned to normal after respective half-life kinetics. Differences between predefined groups (chemotherapy, TM, true/false CSIS) was analyzed with fisher’s exact and chi-square test. Results: Overall, 2616 patient data files were analyzed. Forty-three patients (1.6%) were documented as CSIS of which 27 (63%) were true and 16 (37%) false CSIS. Six (14%) had seminomas and 37 (86%) non-seminomas. In the true CSIS group AFP, ß-HCG, AFP plus ß-HCG and LDH were elevated in 13, 6, 3 and 2 cases. Four true CSIS patients received surveillance, 21 had 3x or 2x courses of BEP (bleomycin, etoposide and cisplatin) and 2 carboplatin. Within the false CSIS group, 2 patients were treated with surveillance, 10 received 3x BEP, one 3x PEI (cisplatin, etoposide and ifosfamid) and 3 had carboplatin. Chi-Square test revealed no difference between true or false CSIS classification in respect to application of chemotherapy (any chemotherapy, p = 0.83). Relapse-free survival after 5 and 10 years was 88.9% and 77.8%, respectively. Three patients in the true CSIS group relapsed (2 seminomas had carboplatin, 1 non-seminoma had surveillance). All relapses were treated with 3 courses of BEP with no documented death in the CSIS population. Conclusions: Overall, less than 2% of all TGCT were documented CSIS of which 37% were falsely classified. We report a high proportion of relapse-free survival in CSIS treated with surveillance or BEP with a high heterogeneity in treatment patterns. Correct classification of CSIS remains of critical importance to avoid toxicity for patients that could be safely treated with surveillance.
Erratum. Differential Health Care Use, Diabetes-Related Complications, and Mortality Among Five Unique Classes of Patients With Type 2 Diabetes in Singapore: A Latent Class Analysis of 71,125 Patients. Diabetes Care 2020;43:1048–1056
Authors: Jun Jie Benjamin Seng, Yu Heng Kwan, Vivian Shu Yi Lee, Chuen Seng Tan, Sueziani Binte Zainudin, Julian Thumboo, Lian Leng Low
Journal: Diabetes Care (2020)

An error occurred in the reporting of data in Table 2, “Health care use (yearly), incidence of diabetes-related complications from 2013 to 2016, …
Socioeconomic status based on race in early-stage anal squamous cell carcinoma undergoing locoregional therapy.
Authors: Suleyman Yasin Goksu, Muhammet Ozer, Muhammad Shaalan Beg, Syed Mohammad Ali Kazmi, Aravind Sanjeevaiah, David Hsieh, Todd Anthony Aguilera, Mary Claire Maxwell, Nina Niu Sanford
Journal: Journal of Clinical Oncology (2020)

4056 Background: Anal Squamous Cell Cancer (ASCC) is a highly curable cancer. Underserved and vulnerable populations are particularly at risk of developing this disease. We aimed to study racial disparities and overall survival (OS) in patients with ASCC who received radiation therapy (RT) or chemo-RT (CRT) using the National Cancer Database. Methods: We identified adult patients with early-stage (stage I-II) ASCC diagnosed between 2004-2016 who underwent RT or CRT. We compared the clinical and treatment characteristics of white and black patients. The chi-square test was used for categorical variables. Kaplan-Meier and Cox regression method performed for survival analyses. We used 1:1 nearest neighbor propensity score matching to eliminate selection bias. Results: A total of 10,014 patients; 90.2% were white and 9.8% were black. White patients were more likely to be female, older age, have higher rate high-school education, private insurance, higher income, and travel a longer distance (all p &lt; .001). Black patients were more likely to be higher comorbidity score and be treated at an academic/research facility. White patients had a higher rate of CRT and significantly better overall survival (OS) as compared to black patients (5-year survival 76% vs. 70%, p &lt; .001) which persisted after propensity score matching (5-year survival 76% vs. 70%, p = .002). This difference continued after adjusting for clinically important factors, including HPV status (unmatched p &lt; .03, matched p = .008). In the patients who received CRT, white patients were associated with improved OS versus black patients (unmatched 77% vs. 71%, p &lt; .001; matched 77% vs. 71%, p = .011), and even after multivariate Cox analysis (unmatched p &lt; .001; matched .014) (Table). Conclusions: White patients had significantly better OS as compared to black patients with early-stage ASCC as well as in the patients who received CRT. White patients were associated with high education level, higher income, and private insurance. The rate of HPV positive was similar among groups. Further investigations are needed to enlighten these disparities and target the increase education of the population at risk. [Table: see text]
Preliminary safety, efficacy and pharmacokinetics (PK) results of KN026, a HER2 bispecific antibody in patients (pts) with HER2-positive metastatic breast cancer.
Authors: Dongmei Ji, Jian Zhang, Weina Shen, Yiqun Du, June Xu, Jing Yang, Xin Luo, Paul Kong, Fei Yang, Xi-Chun Hu
Journal: Journal of Clinical Oncology (2020)

1041 Background: KN026 is a novel bispecific antibody that simultaneously binds to two distinct HER2 epitopes, the same domains as trastuzumab (ECD4) and pertuzumab (ECD2). It blocks ligand-dependent and independent tumor growth and enhances HER2 receptor internalization. In preclinical studies, KN026 showed activity in trastuzumab plus pertuzumab resistant tumor cell lines. This first-in-human study evaluated the safety/tolerability, pharmacokinetics (PK), and preliminary efficacy of KN026 monotherapy. Methods: This dose-escalation and expansion study enrolled Chinese patients (pts) with metastatic breast cancer who have failed prior anti-HER2 therapy. All pts intravenously received KN026 monotherapy at ascending dose of 5 mg/kg (QW), 10 mg/kg (QW), 20 mg/kg (Q2W) or 30 mg/kg (Q3W). Dose limiting toxicity (DLT) evaluation period was 28 days for QW and Q2W, and 21 days for Q3W. Efficacy evaluation was performed by RECIST 1.1 every 6 weeks and safety assessment according to CTCAE v 4.03. Results: As of the Jan, 22, 2020, 63 pts [median age: 54 years (31~69)] enrolled and 62 pts were included in the efficacy analysis. 41 pts remained on treatment and 22 pts discontinued treatment due to disease progression (n = 21) and adverse events (n = 1). The median treatment duration was 12 weeks (range: 4~62 weeks). Median prior lines of therapies are 3 (range: 1~15), and median prior lines of HER2 target therapies are 2 (range: 1~12). No DLTs were observed. Treatment-related AEs (TRAEs) occurred in 49 pts and 4 pts experienced 4 grade 3 TRAE (hypertension, infusion related reaction, transaminases increased and ventricular arrhythmia). The common (≥ 10%) TRAE were pyrexia (23.8%), diarrhea (19.0%), aspartate aminotransferase increased (15.9%), neutrophil count decreased (11.1%) and white blood cell count decreased (11.1%). The objective response rate at recommended Phase 2 dose levels (n = 56) was 32.1% (95% CI 20.3, 46.0) and disease control rate 76.8% (95% CI 63.6, 87.0). Pharmacokinetic analysis showed exposure (C max and AUC 0-t ) of KN026 increased by dose. The recommended Phase 2 dose (RP2D) were 20 mg/kg Q2W and 30 mg/kg Q3W. Conclusions: KN026 is well tolerated and has demonstrated encouraging anti-tumor activity in HER2-positive breast cancer patients who have failed standard anti-HER2 therapies. The recommended Phase 2 dose (RP2D) of KN026 were 20 mg/kg Q2W and 30 mg/kg Q3W. Phase II trials in various HER2-positive and HER2-low/intermediate solid tumors are currently ongoing. Clinical trial information: NCT03619681 .
武汉市居民非酒精性脂肪性肝病及代谢综合征现况调查和相关性分析
Authors: 张利莉, 袁莉, 李琴, 汪英
Journal: BMJ (2010)

本研究旨在通过分析非酒精性脂肪性肝病(non-alcoholicfatty liver disease,NAFLD)及代谢综合征(metabolic syndrome,MS)在居民中的分布特点、患病情况及其相关性,为防治NAFLD及MS提供科学依据。
MicroRNAs involved in immune response as prognostic markers in early and metastatic breast cancer.
Authors: Chara Papadaki, Konstantina Thomopoulou, George Koronakis, Alexia A Monastirioti, Maria A. Papadaki, Kostas Kalbakis, Sofia Agelaki, Dimitrios Mavroudis
Journal: Journal of Clinical Oncology (2020)

e15528 Background: MicroRNAs (miRNAs) are involved in the regulation of immune response and have an important role in immune escape. We analyzed the expression levels of plasma miR-10b, miR-126, miR-19α, miR-20α and miR-155, which regulate tumor-immune interactions and investigated their prognostic implications in patients with early (eBC) and metastatic (mBC) breast cancer. Methods: Blood samples were obtained before treatment from 140 and 64 patients with eBC and mBC, respectively. Plasma miRNA expression levels were assessed by qRT-PCR and expression was classified as high or low according to the median values. Results: A panel of four miRNAs (miR-19a, miR-20a, miR-126 and miR-155) could discriminate eBC from mBC (AUC 0.802, p &lt; 0.001). In early disease, miR-10b (p = 0.022) and miR-155 (p = 0.005) expression was lower in relapsed (n = 46) compared to non-relapsed (n = 94) patients; miR-155 expression along with lymph node infiltration and tumor grade had increased ability to predict relapse (AUC = 0.775; p = 0.003). In addition, miR-10b (p = 0.015), miR-19a (p = 0.003), miR-20a (p = 0.012), miR-126 (p = 0.001) and miR-155 (p &lt; 0.001) expression levels were lower in patients with early relapse (relapse at ≤2 years). MiR-155 and miR-19a had the highest performance in discriminating early relapse (AUC 0.855; p &lt; 0.001 and AUC = 0.729; p = 0.003, respectively), whereas, combined mir-155 and miR-19a expression further increased the accuracy of prediction (AUC = 0.867; p &lt; 0.001). In eBC, the number of infiltrated lymph nodes and low miR-10b independently predicted for shorter DFS (p = 0.001 and p = 0.03, respectively) and axillary lymph nodes for shorter OS (p = 0.003). In the triple negative subgroup, low miR-155 strongly predicted for shorter DFS (p = 0.037). In mBC, recurrent disease and low miR-10b expression independently predicted for shorter PFS (p = 0.001 and p = 0.017, respectively), whereas performance status of 2 independently predicted for shorter OS (p = 0.03). Conclusions: Deregulated expression of circulating miRNAs involved in tumor-immune interactions can discriminate disease status in BC and independently predicts for patients’ outcome in early and mBC. Our results further support the notion that circulating miRNAs represent a useful prognostic tool in patients with BC.
Using Electronic Health Record Portals to Improve Patient Engagement: Research Priorities and Best Practices
Authors: Courtney R. Lyles, Eugene C. Nelson, Susan Frampton, Patricia C. Dykes, Anupama G. Cemballi, Urmimala Sarkar
Journal: Annals of Internal Medicine (2020)

Ninety percent of health care systems now offer patient portals to access electronic health records (EHRs) in the United States, but only 15% to 30% of patients use these platforms. Using PubMed, the authors identified 53 studies published from September 2013 to June 2019 that informed best practices and priorities for future research on patient engagement with EHR data through patient portals, These studies mostly involved outpatient settings and fell into 3 major categories: interventions to increase use of patient portals, usability testing of portal interfaces, and documentation of patient and clinician barriers to portal use. Interventions that used one-on-one patient training were associated with the highest portal use. Patients with limited health or digital literacy faced challenges to portal use. Clinicians reported a lack of workflows to support patient use of portals in routine practice. These studies suggest that achieving higher rates of patient engagement through EHR portals will require paying more attention to the needs of diverse patients and systematically measuring usability as well as scope of content. Future work should incorporate implementation science approaches and directly address the key role of clinicians and staff in promoting portal use.
充分认识嗜酸粒细胞性支气管炎
Authors: 丁东杰
Journal: BMJ (2007)

1989年加拿大医生Gibson等[1]报道了7例慢性咳嗽患者,其咳嗽时间＞3个月,胸部X线正常,肺功能正常,气道反应性不高,支气管激发试验阴性,痰中嗜酸粒细胞＞3%,用糖皮质激素治疗有效,而对其他治疗无效.因其与支气管哮喘不同,后者支气管激发试验为阳性,因此命名为非哮喘性嗜酸粒细胞性支气管炎,以后对本病的报道逐渐增加,张永祥等[2]于2002年首先在国内报道了9例,其后马洪明等[3]又详细报道了13例.由于本病比较常见,是慢性咳嗽常见的原因之一,全科医生应对其有较详细的了解。
Ancestry-specific predisposing germline variants in cancer
Authors: Ninad Oak, Andrew D. Cherniack, R. Jay Mashl, Fred R. Hirsch, Li Ding, Rameen Beroukhim, Zeynep H. Gümüş, Sharon E. Plon, Kuan-lin Huang
Journal: Genome Medicine (2020)

Abstract Background Distinct prevalence of inherited genetic predisposition may partially explain the difference of cancer risks across ancestries. Ancestry-specific analyses of germline genomes are required to inform cancer genetic risk and prognosis of diverse populations. Methods We conducted analyses using germline and somatic sequencing data generated by The Cancer Genome Atlas. Collapsing pathogenic and likely pathogenic variants to cancer predisposition genes (CPG), we analyzed the association between CPGs and cancer types within ancestral groups. We also identified the predisposition-associated two-hit events and gene expression effects in tumors. Results Genetic ancestry analysis classified the cohort of 9899 cancer cases into individuals of primarily European ( N = 8184, 82.7%), African ( N = 966, 9.8%), East Asian ( N = 649, 6.6%), South Asian ( N = 48, 0.5%), Native/Latin American ( N = 41, 0.4%), and admixed ( N = 11, 0.1%) ancestries. In the African ancestry, we discovered a potentially novel association of BRCA2 in lung squamous cell carcinoma (OR = 41.4 [95% CI, 6.1–275.6]; FDR = 0.002) previously identified in Europeans, along with a known association of BRCA2 in ovarian serous cystadenocarcinoma (OR = 8.5 [95% CI, 1.5–47.4]; FDR = 0.045). In the East Asian ancestry, we discovered one previously known association of BRIP1 in stomach adenocarcinoma (OR = 12.8 [95% CI, 1.8–90.8]; FDR = 0.038). Rare variant burden analysis further identified 7 suggestive associations in African ancestry individuals previously described in European ancestry, including SDHB in pheochromocytoma and paraganglioma, ATM in prostate adenocarcinoma, VHL in kidney renal clear cell carcinoma, FH in kidney renal papillary cell carcinoma, and PTEN in uterine corpus endometrial carcinoma. Most predisposing variants were found exclusively in one ancestry in the TCGA and gnomAD datasets. Loss of heterozygosity was identified for 7 out of the 15 African ancestry carriers of predisposing variants. Further, tumors from the SDHB or BRCA2 carriers showed simultaneous allelic-specific expression and low gene expression of their respective affected genes, and FH splice-site variant carriers showed mis-splicing of FH . Conclusions While several CPGs are shared across patients, many pathogenic variants are found to be ancestry-specific and trigger somatic effects. Studies using larger cohorts of diverse ancestries are required to pinpoint ancestry-specific genetic predisposition and inform genetic screening strategies.
Effects of different nutrition intervention on alimentary tract reconstruction in knowledge and practice nutrition and efficacies of patients with type 2 diabetes mellitus
Authors: Ziqin Wang, Yanrong Liu, Xia Wang, Hongbin Liu
Journal: BMJ (2014)

A total of 206 patients of type 2 diabetes mellitus (T2DM) were assigned into the trial group (n=156) and the control group (n=50) according to whether real object-based diabetic diet was provided. Traditional nutritional education for both groups during hospitalization. The patients in the trial group received a real object-based diabetic diet guided by a nutritionist who adjusted feeding regimens and skills before and after operation. The control group had a free access to a normal diet. The patient understanding of knowledge, attitude and practice (KAP) was examined by nutrition surveys. And their postoperative nutrition states and complications were assessed by questionnaires during a 6-month follow-up. The total average score of cognitive divided was 93.4±7.5, the average score of diet therapy knowledge 13.8±1.6 and the average scores of attitude and practice 9.6±1.9 and 32.2±3.9. Significant differences existed between two groups (P<0.05). The incidence rates of hypoglycemia, hyperglycemia and gastrointestinal obstruction were lower than the control group (P<0.05, P<0.01). It suggested that real object-based diabetic diet guidance plus traditional nutrition education could improve the KAP level and may lower the incidence of postoperative complications in T2DM patients with gastric bypass.


Key words: 
Diet therapy; Diabetes mellitus, type 2
Primary adult retroperitoneal sarcoma (RS): Comprehensive genomic profiling (CGP) study.
Authors: Andrea Necchi, Petros Grivas, Gennady Bratslavsky, Jonathan Keith Killian, Douglas I. Lin, Erik Abraham Williams, Shakti H. Ramkissoon, Eric Allan Severson, Brian Michael Alexander, Jeffrey Venstrom, Venkataprasanth P. Reddy, Kimberly McGregor, Julia Andrea Elvin, Alexa Betzig Schrock, Dean Pavlick, Dexter X Jin, Sally E. Trabucco, Natalie Danziger, Jeffrey S. Ross
Journal: Journal of Clinical Oncology (2020)

11541 Background: We performed CGP on 315 cases of RS to discover targetable genomic alterations (GA) and their potential impact on potential targeted and immunotherapy (IO) selection. Methods: FFPE tissues from 315 clinically advanced RS tissues underwent hybrid-capture based CGP (DNA and RNA). Tumor mutational burden (TMB) was determined on up to 1.2 Mbp of sequenced DNA, and tumor cell PD-L1 expression was determined by IHC (Dako 22C3) (low = 1-49%; High = &gt;50% tumor cell staining). Results: 155 liposarcomas (LPS), 74 leiomyosarcomas (LMS), 46 pleomorphic sarcomas (PLS), 7 solitary fibrous tumors (SFT), 6 malignant peripheral nerve sheath tumors (MPNST), 5 synovial sarcomas (SS) and 5 dendritic follicular cell sarcomas (DFCS) were studied; 17 cases were excluded. Median age was 59. There were 5.1 GA/tumor, none were MSI-high, median TMB was low at 2.4; PD-L1 IHC staining was low-positive in 21% and high-positive in 5%. MPNST patients were younger (median 28 years vs. 59 years). LPS was more frequent in men and LMS in women. LPS had more GA/tumor than LMS, with DFCS having the highest and SS the lowest. TP53 and RB1 GA were the highest in LMS and CDK4/6 and MDM2 GA the highest in LPS. Molecular targets in mTOR pathway were most frequently altered. Targetable gene fusions in ALK, ROS1 and NTRK1-3 were rare. Non-targetable fusions in HMGA2 (LPS and some PLS), STAT6 (SFT) and SS18 (SS) were also identified. Conclusions: RS in our cohort are predominantly composed of LPS, LMS and PLS and we identified a small proportion with “actionable” genomic targets on CGP, albeit in association with uncertain mTOR pathway inhibitor benefit and uncommon targetable kinase fusions. Our analysis suggests that a small subset of RS may respond to immunotherapy based on putative biomarker expression. [Table: see text]
Effect evaluation for family doctor precision contract service in Sijiqing Community Health Service Center
Authors: Fang Qian, Wenyun Dai
Journal: BMJ (2018)

Hangzhou Sijiqing Community Health Service Center has started the precise contract service mode with the characteristics of competitive contract, regional medical alliance and team service form 2016, which improved hypertensive and diabetic patients management in community.After adopting the precision contract service mode, the contracting rate of hypertensive and diabetic patients increased from 56.1% (2 680/4 777)to 81.6% (5 602/6 863), the rate of referral to regional medical alliance increased from 26.1%(2 678/10 259)to 44.4%(5 589/12 589), consultation rate of contracted doctor increased from 47.1%(54 603/115 986) to 56.3%(93 219/165 725), contract renewing rate increased from 41.3%(5 794/10 822) to 67.2%(7 282/10 838), and the rate of home nursing care in increased from 9.5%(47/495)to 61.5%(392/637). The precise family doctor contract service is an effective mode for primary care, which improves the management rate of hypertensive and diabetic patients, provides continuous medical service, facilitates referral and home nursing service, and promotes the continuity of contract service.


Key words: 
Community health center; Contractual services; Patient transfer
结直肠原发性套细胞淋巴瘤一例并文献复习
Authors: 沈洪章, 朱家沂, 伏亦伟, 杨斌, 杨传春
Journal: BMJ (2011)

患者男,67岁,因腹痛、腹胀半月余于2009年4月21日人院.腹痛呈间歇性隐痛,以脐周及右下腹为主,无腰背部及会阴等部位放射,纳差,大便次数增多,每日3～4次,为黄色稀便,时有黏液、脓血,睡眠欠佳,无发热、呕吐,自觉近2个月来消瘦明显(体重下降约5 kg).体检:血压130/85 mmHg(17.3/11.3 kPa),皮肤及巩膜无黄染,浅表淋巴结不肿大,心肺无异常,腹软,脐周轻压痛,未扪及包块,肝脾肋下未及,腹水征可疑,肠鸣音活跃.血常规:血红蛋白132 g/L,血小板91×1012/L,红细胞4.7×1012/L,分类淋巴细胞0.715,中性粒细胞0.225.肝肾功能、心电图及X线胸片无异常. 关键词：淋巴瘤;膜细胞