Mand'áková P, Campr V, Kodet R
Ustav patologie a molekulární medicíny 2. LF UK a FNM, Praha.
Cas Lek Cesk. 2003;142(11):651-5.
Immunophenotyping of malignant lymphomas becomes necessary for the correct classification, for the design of therapy and for prognosis projection (WHO). Although the spectrum of classic immunohistochemical (IHC) examinations in paraffin embedded or frozen sections has recently considerably extended, IHC should preferably be combined with flow cytometry. The main advantage of flow cytometry is a synchronous application of two or more antibodies marked with various fluorochromes in one sample. The method is limited by utilizing native material only.
The flow cytometry combined with histological and IHC investigations were used in diagnosis of primary non-Hodgkin's lymphomas of B-cell origin (B-NHL) and for bone marrow staging or restaging. We studied 90 patients with confirmed or suspected B-NHL and we found a good correlation in 89% of samples of primary lymphomas and in 85% of bone marrow samples when IHC and flow cytometry results were compared. The overall efficacy of the flow cytometry determination in lymphoma infiltration of the samples was 89%.
Immunophenotyping utilizing flow cytometry contributes to diagnosis and classification of B-cell lymphomas in the significant proportion of investigated patients. In some cases it is even unnecessary to employ IHC examination of tissue sections. The method is especially suitable for determination of monoclonal populations of B-cells by detection of cell surface markers because it is more specific and sensitive than IHC. The immunophenotyping by flow cytometry as an auxiliary method and in correlation with morphological findings it can make the diagnosis of B-cell lymphomas faster and more specific.
恶性淋巴瘤的免疫表型分析对于正确分类、治疗方案设计及预后预测(世界卫生组织)而言变得十分必要。尽管近期石蜡包埋或冰冻切片中经典免疫组织化学(IHC)检查的范围已大幅扩展,但IHC最好与流式细胞术相结合。流式细胞术的主要优势在于可在一个样本中同步应用两种或更多种标记有不同荧光染料的抗体。该方法仅局限于使用天然材料。
流式细胞术联合组织学及IHC检查用于B细胞起源的原发性非霍奇金淋巴瘤(B-NHL)的诊断以及骨髓分期或再分期。我们研究了90例确诊或疑似B-NHL的患者,当比较IHC和流式细胞术结果时,发现原发性淋巴瘤样本中有89%以及骨髓样本中有85%存在良好的相关性。流式细胞术测定在样本淋巴瘤浸润中的总体效能为89%。
在相当比例的受调查患者中,利用流式细胞术进行免疫表型分析有助于B细胞淋巴瘤的诊断和分类。在某些情况下甚至无需对组织切片进行IHC检查。该方法特别适用于通过检测细胞表面标志物来确定B细胞的单克隆群体,因为它比IHC更具特异性和敏感性。作为一种辅助方法且与形态学结果相关联,流式细胞术免疫表型分析可使B细胞淋巴瘤的诊断更快且更具特异性。