Department of Pathology, UMASS Memorial Medical Center, Worcester, MA 01605, USA.
Am J Clin Pathol. 2013 May;139(5):662-9. doi: 10.1309/AJCP7G4VMYZJQVFI.
Detection of cytogenetic abnormalities requires successful culture of the clonal population to obtain metaphase chromosomes for study, and as such, has been hampered by low mitotic indices of mature B cells in culture. Our study presents data on the improved abnormality detection rate with the use of a CpG-oligonucleotide/interleukin 2 (OL/IL-2) culture protocol for mature B-cell neoplasms, including chronic lymphocytic leukemia (CLL) and non-CLL specimens. The increased detection rate of abnormalities, compared with unstimulated culture and traditional pokeweed mitogen culture, was statistically significant for both CLL and non-CLL neoplasms. For CLL specimens, our data also showed that for cytogenetically visible aberrations, OL/IL-2 was as, if not more, sensitive than detection with interphase fluorescence in situ hybridization (iFISH). Use of OL/IL-2 allowed a number of abnormalities to be detected, which were not covered by specific iFISH panels, especially balanced translocations. Therefore, OL/IL-2 stimulation improves diagnostic sensitivity and increases discovery rate of novel prognostic findings.
细胞遗传学异常的检测需要成功培养克隆群体,以获得用于研究的中期染色体,因此,由于成熟 B 细胞在培养中的有丝分裂指数低,这种检测受到了阻碍。我们的研究提供了数据,表明使用 CpG-寡核苷酸/白细胞介素 2(OL/IL-2)培养方案可提高成熟 B 细胞肿瘤(包括慢性淋巴细胞白血病(CLL)和非 CLL 标本)的异常检出率。与未刺激培养和传统美洲商陆丝裂原培养相比,CLL 和非 CLL 肿瘤的异常检出率均有统计学意义显著增加。对于 CLL 标本,我们的数据还表明,对于细胞遗传学可见的畸变,OL/IL-2 的敏感性与间期荧光原位杂交(iFISH)检测相当,如果不比后者更敏感的话。OL/IL-2 的使用可以检测到许多异常,而这些异常无法被特定的 iFISH 面板覆盖,尤其是平衡易位。因此,OL/IL-2 刺激可提高诊断敏感性并增加新的预后发现的检出率。