Cady Francois M, Morice William G
Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
Clin Lab Med. 2007 Sep;27(3):513-32, vi. doi: 10.1016/j.cll.2007.05.004.
Flow cytometry is frequently used in the evaluation of potential T-cell lineage lymphoproliferative disorders. Although flow cytometry is a useful tool, interpretation of the results can be challenging, because T-cells lack an easily analyzed structural element that can provide a surrogate marker of clonality such as immunoglobulin light chains on B-cells. Thus, routine T-cell phenotyping assays in the clinical laboratory require the comprehensive analysis of several T-cell-associated antigens. Although the detection of aberrant patterns of T-cell antigen expression can be helpful in establishing a diagnosis of T-cell malignancy, these patterns are not always disease specific, and some can overlap significantly with T-cell phenotypes observed in reactive conditions. Thus, arriving at an accurate diagnosis requires correlation of the flow cytometry results with the clinical, morphologic, and molecular results. Furthermore, the integration of these varied pieces of information into a cogent diagnosis requires an understanding of T-cell biology. In this review, the use of flow cytometry to identify T-cell lymphoproliferative disorders, particularly in peripheral blood and bone marrow specimens, is discussed, and a brief overview of T-cell biology to aid the reader in understanding the significance of the flow cytometry results is provided.
流式细胞术常用于评估潜在的T细胞系淋巴增殖性疾病。尽管流式细胞术是一种有用的工具，但结果的解读可能具有挑战性，因为T细胞缺乏易于分析的结构元件，无法提供如B细胞上免疫球蛋白轻链那样的克隆性替代标志物。因此，临床实验室中的常规T细胞表型分析检测需要对几种T细胞相关抗原进行综合分析。虽然检测T细胞抗原表达的异常模式有助于诊断T细胞恶性肿瘤，但这些模式并不总是具有疾病特异性，有些可能与反应性条件下观察到的T细胞表型有显著重叠。因此，要做出准确诊断需要将流式细胞术结果与临床、形态学和分子结果相关联。此外，将这些不同的信息整合为一个有说服力的诊断需要了解T细胞生物学。在这篇综述中，讨论了使用流式细胞术识别T细胞淋巴增殖性疾病，特别是在外周血和骨髓标本中的应用，并简要概述了T细胞生物学，以帮助读者理解流式细胞术结果的意义。
