Szánthó Eszter, Kárai Bettina, Ivády Gergely, Bedekovics Judit, Szegedi István, Petrás Miklós, Ujj György, Ujfalusi Anikó, Kiss Csongor, Kappelmayer János, Hevessy Zsuzsanna
Department of Laboratory Medicine.
Department of Pathology.
Appl Immunohistochem Mol Morphol. 2018 May/Jun;26(5):305-315. doi: 10.1097/PAI.0000000000000519.
Disseminating cells of a primary solid tumor may represent the origin of metastases and relapses. We aimed at comparing the diagnostic efficacy of multicolor flow cytometry (MFC) and morphology/immunohistochemistry (IHC) in the detection of disseminated tumor cells in the bone marrow (BM) and body fluids of patients with solid tumors, and in pediatric neuroblastoma cases. We investigated 72 samples retrospecively from 50 patients by MFC. Morphology/IHC data were available in 48 cases. In the first cohort, 36 samples derived from 34 patients with various forms of suspected and proven solid tumors and in the second cohort, 36 samples of 16 children with suspected and proven neuroblastoma were analyzed at diagnosis or during follow-up in a 4-color setting by MFC, and the results were compared with those obtained by IHC. In the group of various solid tumors, we found 91% concordance between IHC and MFC, and it was 65% in the neuroblastoma group, and 77% overall. Detection of disseminated tumor cells was found to be more effective by MFC in de novo neuroblastoma samples (100% vs. 86%). The advantage of MFC was even more pronounced when minimal residual disease was evaluated (efficacy, 92% vs. 68%). In contrast, efficacy of IHC was 100% in the group of various solid tumors, whereas it was 91% for MFC. We conclude that MFC and IHC are both essential tools for examining infiltration of BM and body fluids by disseminating solid tumor cells. In the case of neuroblastoma, however, minimal residual disease detection by MFC in a hypoplastic/aplastic BM environment was more effective than IHC, as considerably more cells could be analyzed.
原发性实体瘤的播散细胞可能是转移和复发的起源。我们旨在比较多色流式细胞术（MFC）与形态学/免疫组织化学（IHC）在检测实体瘤患者骨髓（BM）和体液以及小儿神经母细胞瘤病例中播散肿瘤细胞的诊断效能。我们通过MFC对50例患者的72份样本进行了回顾性研究。48例有形态学/IHC数据。在第一组中，36份样本来自34例各种疑似和确诊实体瘤患者，在第二组中，对16例疑似和确诊神经母细胞瘤儿童的36份样本在诊断时或随访期间采用四色设置通过MFC进行分析，并将结果与IHC获得的结果进行比较。在各种实体瘤组中，我们发现IHC与MFC之间的一致性为91%，在神经母细胞瘤组中为65%，总体为77%。发现MFC在初发神经母细胞瘤样本中检测播散肿瘤细胞更有效（100%对86%）。在评估微小残留病时，MFC的优势更为明显（效能为92%对68%）。相比之下，IHC在各种实体瘤组中的效能为100%，而MFC为91%。我们得出结论，MFC和IHC都是检查实体瘤播散细胞对BM和体液浸润的重要工具。然而，在神经母细胞瘤的情况下，在发育不全/再生障碍性BM环境中通过MFC检测微小残留病比IHC更有效，因为可以分析更多的细胞。
