Babusíková O, Zelezníková T
Cancer Research Institute, Slovak Academy of Sciences, 833 91 Bratislava, Slovak Republic.
Neoplasma. 2004;51(5):345-51.
The usefulness of multiparameter flow cytometric (FC) analysis of cerebrospinal fluid (CSF) was evaluated in leukemia/lymphoma patients having central nervous system (CNS) involvement of the disease. In 12 specimens of 8 patients with different types of leukemia/lymphoma (one case of T-ALL, 3 cases of early B-cell ALL, one case of AML, and 3 proven or suspicious NHL cases) the presence of pathological clone in CSF has been confirmed or excluded. The phenotypic patterns of CSF cells were defined according to those of bone marrow (BM)/peripheral blood (PB) at diagnosis or during follow-up of the same patients. Furthermore, in one case of suspicious CNS infiltration of NHL, the pathological clone was characterized as a highly suspicious of solid tumor and was proved to be a lung cancer metastasis. The definition was made on the basis of CD45 (common leukocyte antigen) and other studied CD markers negativity. The exact comparison of immunophenotypic profiles of specimens from different sites (CSF, BM, PB) of the same patient has been performed and no phenotypic changes were found. In some CSF specimens, where no cells of suspicious pathological clone were detected, in 4-color analysis only normal lymphocyte population was found even in small cell samples (even if the cellularity was < than 0.3x10-6). In these populations the high values of T-cells (CD3+) predominated and the high prevalence of CD4+ over CD8+ cells, and an almost total lack of B-lymphocytes was found. Our results suggest that positive CSF immunology is a useful indicator of malignancy and reflects leptomeningeal involvement. Simultaneously we demonstrated that FC analysis of CSF in the aim to detect possible CSF seeding of leukemia/lymphoma is a reliable and quick technique.
对患有白血病/淋巴瘤且疾病累及中枢神经系统（CNS）的患者，评估了脑脊液（CSF）多参数流式细胞术（FC）分析的实用性。在8例不同类型白血病/淋巴瘤患者（1例T细胞急性淋巴细胞白血病、3例早期B细胞急性淋巴细胞白血病、1例急性髓细胞白血病以及3例确诊或疑似非霍奇金淋巴瘤病例）的12份标本中，已证实或排除了CSF中病理性克隆的存在。根据同一患者诊断时或随访期间骨髓（BM）/外周血（PB）的表型模式来定义CSF细胞的表型模式。此外，在1例疑似非霍奇金淋巴瘤中枢神经系统浸润的病例中，病理性克隆被高度怀疑为实体瘤，后来证实是肺癌转移。该定义基于CD45（常见白细胞抗原）及其他所研究的CD标志物阴性。对同一患者不同部位（CSF、BM、PB）标本的免疫表型谱进行了精确比较，未发现表型变化。在一些未检测到可疑病理性克隆细胞的CSF标本中，即使在小细胞样本中（即使细胞计数<0.3×10⁻⁶），四色分析也仅发现正常淋巴细胞群体。在这些群体中，T细胞（CD3⁺）高值占主导，CD4⁺细胞比CD8⁺细胞占比高，且几乎完全缺乏B淋巴细胞。我们的结果表明，CSF免疫阳性是恶性肿瘤的有用指标，反映软脑膜受累。同时我们证明，旨在检测白血病/淋巴瘤可能的CSF播散的CSF流式细胞术分析是一种可靠且快速的技术。
