van Dongen J J, Hooijkaas H, Adriaansen H J, Hählen K, van Zanen G E
Tijdschr Kindergeneeskd. 1986 Apr;54(2):41-5.
Several different techniques have been used for the detection of low numbers of malignant cells in patients with leukemia or non-Hodgkin lymphoma, e.g. cytomorphology, cytogenetics, recombinant DNA techniques and immunological marker analysis. The detection limit of most techniques, however, is not lower than 1% (i.e. 1 malignant cell in 100 normal cells). Most immunological markers represent differentiation antigens, which are also expressed by normal cells. Nevertheless, it is possible to use these differentiation antigens for the detection of low numbers of malignant cells, since the occurrence of positive cells outside their normal homing areas can be indicative of malignancy. A useful marker for the detection of low numbers of acute lymphoblastic leukemia (ALL) cells in the cerebrospinal fluid is terminal deoxynucleotidyl transferase (TdT). Although TdT positive cells normally occur in low frequencies in bone marrow and blood, the combined detection of TdT and a T cell marker at the single cell level, allows detection of very low numbers of T-ALL cells. The detection limit of this technique is at least 0.01%. Such a low detection limit allows the adjustment of remission and staging criteria as well as the individualization of therapy.
已经使用了几种不同的技术来检测白血病或非霍奇金淋巴瘤患者中少量的恶性细胞，例如细胞形态学、细胞遗传学、重组DNA技术和免疫标记分析。然而，大多数技术的检测限不低于1%（即100个正常细胞中有1个恶性细胞）。大多数免疫标记代表分化抗原，正常细胞也表达这些抗原。尽管如此，仍有可能利用这些分化抗原检测少量的恶性细胞，因为在其正常归巢区域之外出现阳性细胞可能表明存在恶性肿瘤。检测脑脊液中少量急性淋巴细胞白血病（ALL）细胞的一种有用标记是末端脱氧核苷酸转移酶（TdT）。虽然TdT阳性细胞通常在骨髓和血液中以低频率出现，但在单细胞水平上联合检测TdT和T细胞标记，可以检测到非常少量的T-ALL细胞。该技术的检测限至少为0.01%。如此低的检测限有助于调整缓解和分期标准以及实现治疗个体化。
