Thaler J, Denz H, Gattringer C, Glassl H, Lechleitner M, Dietze O, Huber H
Blut. 1987 Apr;54(4):213-22. doi: 10.1007/BF00594196.
Cryostat sections of 246 consecutive bone marrow biopsies from 212 patients with lymphoproliferative disease were investigated using a panel of monoclonal antibodies (MOAb's) and an immunoperoxidase technique. Bone marrow involvement was demonstrated by immunohistological examination in 121/160 patients (76%) with non-Hodgkin lymphomas (NHL) and 16/23 patients (70%) with plasma cell malignancies; the definite immunological diagnosis could be performed in 77% and 88%, respectively. Reactivity with the MoAb Ki-67 correlated with clinical parameters: in all cases exhibiting more than 5% positive cells an unfavourable course was seen, independent of the histological subtype. Another MoAb of potential prognostic relevance is KiM 4 b, which reacts with follicular dendritic cells (FDC). Besides the presence of FDC in germinal center tumors (CB/CC and CC-NHL) we found FDC in a minority of cases with B-CLL (5/44) and IC lymphoma (4/18). In the latter group 3/4 patients showed a favourable clinical course (vs 2/14 without FDC). The MoAb Tü 1 could discriminate between the lymphoplasmocytoid (11/12 positive) and the lymphoplasmocytic (0/6 positive) subtype of IC lymphoma and has proven of diagnostic importance. Expression of IL-2 receptors, detected by MoAb anti-Tac (CD 25), was demonstrated on leukemic cells from patients with hairy cell leukemia (100%), B-CLL (82%), IC (61%), CC (50%) and CB/CC lymphoma (50%). A considerable number of reactive T-lymphocytes (5%-60% of tissue cells) were identified among the neoplastic B cells with a predominance of CD4+ cells in most cases with NHL, whereas the CD4+/CD8+ ratio was significantly lower in myelomas and non-infiltrated bone marrows. The potential meaning of these findings is discussed. The immunohistological bone marrow analysis represents an important additional method in the diagnostic procedures of lymphoproliferative diseases involving the bone.
采用一组单克隆抗体（MOAb）和免疫过氧化物酶技术，对212例淋巴增生性疾病患者连续进行的246份骨髓活检的低温切片进行了研究。免疫组织学检查显示，160例非霍奇金淋巴瘤（NHL）患者中有121例（76%）以及23例浆细胞恶性肿瘤患者中有16例（70%）存在骨髓受累；分别有77%和88%的患者能够做出明确的免疫诊断。与单克隆抗体Ki-67的反应性与临床参数相关：在所有显示阳性细胞超过5%的病例中，均观察到病情进展不利，这与组织学亚型无关。另一种具有潜在预后意义的单克隆抗体是KiM 4 b，它与滤泡树突状细胞（FDC）发生反应。除了生发中心肿瘤（CB/CC和CC-NHL）中存在FDC外，我们还在少数B-CLL病例（5/44）和IC淋巴瘤病例（4/18）中发现了FDC。在后一组中，3/4的患者临床病程良好（而无FDC的患者为2/14）。单克隆抗体Tü 1能够区分IC淋巴瘤的淋巴浆细胞样亚型（11/12阳性）和淋巴浆细胞亚型（0/6阳性），已证明具有诊断重要性。通过抗Tac单克隆抗体（CD 25）检测到的IL-2受体表达，在毛细胞白血病（100%）、B-CLL（82%）、IC（61%）、CC（50%）和CB/CC淋巴瘤（50%）患者的白血病细胞上得到证实。在肿瘤性B细胞中发现了大量反应性T淋巴细胞（占组织细胞的5%-60%），在大多数NHL病例中以CD4+细胞为主，而在骨髓瘤和未浸润的骨髓中，CD4+/CD8+比值明显较低。讨论了这些发现的潜在意义。免疫组织学骨髓分析是涉及骨髓的淋巴增生性疾病诊断程序中的一种重要辅助方法。
