Wang Wei, Gao Li, Wang Li-Li, Li Mian-Yang, Li Yu-Yan, Zhao Wei, Xu Yuan-Yuan, Ding Yi, Yu Li
Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2010 Oct;18(5):1204-7.
This study was purposed to investigate the significance of using (FCM) flow cytometry for detection bone marrow involvement by lymphoma cells in untreated patients with B cell non-Hodgkin's lymphoma (B-NHL). Bone marrow samples of 54 patients with B-NHL were analyzed by flow cytometry, morphological method and molecular biology technique. Bone marrow involvement was diagnosed based on the results of morphology, FCM and molecular biology. The results indicated that the positive ratios of bone marrow involvement were different detected by three methods, the most sensitive method was FCM (positive rate was 27.5%), the moderately sensitive method was molecular biology (positive rate was 22.2%), the inferior method was morphology method (positive rate was 5.6%). Combined with three methods, the positive rate increased to 38.9%. The monoclonal B lymphocytes were detected by FCM in fourteen patients, the ratios of kappa light chain/lambda light chain were far beyond the diagnostic threshold. Even in patients with early stage, lymphoma cells still could be detected by FCM in involved bone marrow. Monoclonal B lymphocytes were detected by FCM in three patients who were diagnosed bone marrow involvement by morphological method. The concordance between FCM and molecular biology was relatively high (70.4%, p=0.14). It is concluded that the detection of monoclonal B lymphocytes by using FCM has high sensitivity and accuracy in patients with B-NHL. Evaluation whether the bone marrow has been involved by lymphoma cells should be recommend to every patient with B-NHL before chemotherapy and every disease stages. Combined application of FCM and molecular biology method would enhance diagnostic efficacy.
本研究旨在探讨运用流式细胞术(FCM)检测未经治疗的B细胞非霍奇金淋巴瘤(B-NHL)患者淋巴瘤细胞骨髓浸润的意义。采用流式细胞术、形态学方法及分子生物学技术对54例B-NHL患者的骨髓样本进行分析。根据形态学、流式细胞术及分子生物学结果诊断骨髓浸润情况。结果显示,三种方法检测的骨髓浸润阳性率不同,最敏感的方法是流式细胞术(阳性率为27.5%),中度敏感的方法是分子生物学(阳性率为22.2%),较差的方法是形态学方法(阳性率为5.6%)。三种方法联合使用时,阳性率升至38.9%。流式细胞术在14例患者中检测到单克隆B淋巴细胞,κ轻链/λ轻链比值远超诊断阈值。即使在早期患者中,流式细胞术仍可在受累骨髓中检测到淋巴瘤细胞。在3例经形态学方法诊断为骨髓浸润的患者中,流式细胞术检测到单克隆B淋巴细胞。流式细胞术与分子生物学的一致性相对较高(70.4%,p = 0.14)。结论是,运用流式细胞术检测单克隆B淋巴细胞对B-NHL患者具有较高的敏感性和准确性。建议对每例B-NHL患者在化疗前及各疾病阶段评估骨髓是否被淋巴瘤细胞浸润。联合应用流式细胞术和分子生物学方法可提高诊断效能。