Berliner N, Ault K A, Martin P, Weinberg D S
Blood. 1986 Jan;67(1):80-5.
Previous studies have suggested that analysis of the distribution of surface immunoglobulin light chain isotypes by flow cytometry provides evidence for monoclonality of B cell tumors and may detect populations of circulating tumor cells in patients with lymphoproliferative disease. We have used simultaneous flow cytometry and DNA restriction enzyme analysis on 58 samples of tissue and blood to determine whether lymphocyte populations detected by "kappa/lambda" analysis are indeed monoclonal. In greater than 90% of cases, abnormalities detected by flow cytometry correlated with monoclonal rearrangements of immunoglobulin genes as detected by Southern blot analysis. By analyzing tissue and blood from the same patients, we have also demonstrated that monoclonal circulating cells detected by flow cytometry reflect peripheral circulating tumor cells, since DNA from these cells shows the same immunoglobulin rearrangement as DNA from the original tumors in these patients. Although mixing studies suggested that DNA rearrangement studies were more sensitive than was flow cytometry in detecting minor populations of monoclonal lymphocytes, we found only one case in which this affected the diagnostic accuracy of the kappa/lambda analysis, with one notable exception, that of detection of a monoclonal proliferation of B cells that did not express surface immunoglobulin. The kappa/lambda test thus offers a powerful diagnostic tool in the evaluation of lymphoproliferative disease.
以往的研究表明，通过流式细胞术分析表面免疫球蛋白轻链同种型的分布可为B细胞肿瘤的单克隆性提供证据，并且可能检测出淋巴增殖性疾病患者循环肿瘤细胞群体。我们对58份组织和血液样本同时进行了流式细胞术和DNA限制性酶切分析，以确定通过“κ/λ”分析检测到的淋巴细胞群体是否确实为单克隆性。在超过90%的病例中，流式细胞术检测到的异常与Southern印迹分析检测到的免疫球蛋白基因单克隆重排相关。通过分析同一患者的组织和血液，我们还证明，流式细胞术检测到的单克隆循环细胞反映了外周循环肿瘤细胞，因为这些细胞的DNA显示出与这些患者原始肿瘤DNA相同的免疫球蛋白重排。尽管混合研究表明，DNA重排研究在检测少量单克隆淋巴细胞群体方面比流式细胞术更敏感，但我们仅发现1例这种情况影响了κ/λ分析的诊断准确性，有一个显著例外，即检测到不表达表面免疫球蛋白的B细胞单克隆增殖。因此，κ/λ检测为评估淋巴增殖性疾病提供了一种强大的诊断工具。
