B细胞淋巴瘤骨髓受累的形态学、流式细胞术及细胞遗传学评估

Morphologic, flow cytometric and cytogenetic evaluation of bone marrow involvement in B-cell lymphoma.

作者信息

Gomyo Hiroshi, Shimoyama Manabu, Minagawa Kentaro, Yakushijin Kimikazu, Urahama Norinaga, Okamura Atsuo, Yamamoto Katsuya, Ito Mitsuhiro, Chihara Kazuo, Hayashi Yoshitake, Matsui Toshimitsu

机构信息

Hematology/Oncology, Department of Medicine, Kobe University School of Medicine, Japan.

出版信息

Haematologica. 2003 Dec;88(12):1358-65.

PMID:14687988

Abstract

BACKGROUND AND OBJECTIVES

Flow cytometric immunophenotypic analysis (FC) and cytogenetic analysis are essential techniques for the diagnosis and classification of many hematologic disorders. The roles of these analyses in B-cell lymphoma to detect bone marrow (BM) involvement in clinical staging and to evaluate the effectiveness of treatments have not yet been determined. The aim of this study was to evaluate the usefulness of FC and cytogenetic analysis in the assessment of BM involvement in B-cell lymphoma.

DESIGN AND METHODS

We retrospectively analyzed the usefulness of three-color FC and cytogenetic analysis in detecting BM involvement by examining 104 BM specimens from patients with B-cell lymphoma.

RESULTS

By morphologic evaluation of BM biopsy (BMB), the BM was involved in 11 specimens (10.6%), not involved in 92 specimens (88.5%) and involvement could not be determined in 1 specimen (0.9%). FC identified a monoclonal B-cell population in 24 samples (23.1%). FC detected BM involvement in all but one BMB positive sample, and showed negative results in a BMB undetermined sample. Conclusively, FC found a monoclonal B-cell population in 14 of 92 BMB negative samples (15.2%). In particular, FC detected smaller amounts of BM involvement than did morphologic evaluation. Cytogenetic analysis revealed clonal abnormalities in only 9 of 104 samples (8.7%). However, 2 of these 9 samples were from patients with aggressive lymphoma with complex structural chromosomal abnormalities detectable only by cytogenetic analysis.

INTERPRETATION AND CONCLUSIONS

Although morphologic evaluation of adequate amounts of BMB specimens remains essential for the evaluation of BM involvement, three-color FC is more sensitive in detecting BM disease than morphologic or cytogenetic analysis. Cytogenetic analysis seems to have low sensitivity and specificity, but this method may improve the detection of BM involvement in a small number of aggressive lymphomas that have many mitotic cells.

摘要

背景与目的

流式细胞术免疫表型分析（FC）和细胞遗传学分析是许多血液系统疾病诊断和分类的重要技术。这些分析在B细胞淋巴瘤临床分期中检测骨髓（BM）受累情况以及评估治疗效果方面的作用尚未确定。本研究旨在评估FC和细胞遗传学分析在评估B细胞淋巴瘤BM受累情况中的实用性。

设计与方法

我们回顾性分析了三色FC和细胞遗传学分析在检测B细胞淋巴瘤患者104份BM标本中BM受累情况的实用性。

结果

通过对骨髓活检（BMB）进行形态学评估，11份标本（10.6%）存在BM受累，92份标本（88.5%）未受累，1份标本（0.9%）无法确定是否受累。FC在24个样本（23.1%）中鉴定出单克隆B细胞群体。FC检测出除1份BMB阳性样本外的所有BM受累样本，且在1份BMB无法确定的样本中呈阴性结果。总之，FC在92份BMB阴性样本中的14份（15.2%）中发现了单克隆B细胞群体。特别是，FC检测到的BM受累量比形态学评估少。细胞遗传学分析仅在104个样本中的9个（8.7%）发现了克隆异常。然而，这9个样本中的2个来自侵袭性淋巴瘤患者，其复杂的结构染色体异常仅通过细胞遗传学分析才能检测到。