Sun Xiao-Fei, He Li-Rong, Feng Hai-Lin, Yan Su-Li, Xia Zhong-Jun, Chen Xiao-Qing
Department of Medical Oncology, Cancer Center, Sun Yet-sen University, Guangzhou, Guangdong, PR China.
Ai Zheng. 2003 Nov;22(11):1232-6.
BACKGROUND & OBJECTIVE: Lymphocytic leukemia and bone marrow involvement of non-Hodgkin's lymphoma (NHL) can be diagnosed by bone marrow morphology or lymph node biopsy combined with bone marrow examination. The data of original and differentiation status of tumor can be analyzed by immunophenotype of bone marrow. These are necessary for diagnosis and treatment of lymphocytic malignancy. This study was designed to investigate the value of multiparameter flow cytometry in diagnosis of leukemia and bone marrow involvement of NHL.
The samples from 11 cases of untreated leukemia bone marrow and 41 cases of untreated NHL with bone marrow involvement and 2 cases of bone marrow whose biopsy could not be obtained due to huge mass in mediastinum and abdomen were detected by multiparameter flow cytometry using antibodies of T, B, Myeloid cell series. Three-color staining was done by CD45 combined with two cell series or special phase antibodies. Using CD45/SSC set gate to identify blast cells from mature cells. The samples were analyzed using five parameters [forward scatter (FSC), side scatter(SSC), McAb1-FITC, McAb2-PE, and CD45-cychrome].
Immunophenotype and diagnosis of 11 cases of leukemia were further confirmed by flow cytometry (FCM). Of 41 cases of NHL with bone marrow involvement, 33 cases (80.5%) lymph nodes immunophenotype by pathology diagnosis were consistent with bone marrow immunophenotype by FCM, 8 cases (19.5%) were inconsistent, but right diagnosis were made by combining with clinical presentation, pathology, bone marrow morphology and FCM. Another 2 cases with huge mediastinal mass and abdominal mass were diagnosed as T-NHL and B-NHL by bone marrow morphology and FCM without lymph node biopsy.
Multiparameter flow cytometry of bone marrow can further ascertain the diagnosis of leukemia and NHL with bone marrow involvement. It also gives us data of cells lineage and differentiation status for leukemia and NHL. It is helpful for diagnosis, differential diagnosis, and treatment.
淋巴细胞白血病以及非霍奇金淋巴瘤（NHL）的骨髓受累情况可通过骨髓形态学检查或淋巴结活检联合骨髓检查来诊断。通过骨髓免疫表型可分析肿瘤的原始及分化状态数据。这些对于淋巴细胞恶性肿瘤的诊断和治疗至关重要。本研究旨在探讨多参数流式细胞术在白血病及NHL骨髓受累诊断中的价值。
采用T、B、髓系细胞系列抗体，运用多参数流式细胞术对11例未经治疗的白血病骨髓样本、41例未经治疗且伴有骨髓受累的NHL样本以及2例因纵隔和腹部巨大肿块无法进行活检的骨髓样本进行检测。通过CD45与两个细胞系列或特殊阶段抗体进行三色染色。利用CD45/SSC设置门控以区分原始细胞与成熟细胞。样本采用五个参数[前向散射（FSC）、侧向散射（SSC）、单克隆抗体1 - FITC、单克隆抗体2 - PE以及CD45 - 藻红蛋白]进行分析。
流式细胞术（FCM）进一步证实了11例白血病的免疫表型及诊断。在41例伴有骨髓受累的NHL中，33例（80.5%）经病理诊断的淋巴结免疫表型与FCM检测的骨髓免疫表型一致，8例（19.5%）不一致，但结合临床表现、病理、骨髓形态学及FCM做出了正确诊断。另外2例纵隔和腹部巨大肿块患者，未进行淋巴结活检，通过骨髓形态学及FCM诊断为T - NHL和B - NHL。
骨髓多参数流式细胞术可进一步明确白血病及伴有骨髓受累的NHL的诊断。它还为白血病和NHL提供了细胞系及分化状态的数据。有助于诊断、鉴别诊断及治疗。
