Hematopathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Diagnostic Molecular Pathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Cytometry B Clin Cytom. 2022 May;102(3):189-198. doi: 10.1002/cyto.b.22070. Epub 2022 Apr 22.
Accurate Sezary cell detection in peripheral blood of mycosis fungoides/Sezary syndrome (MF/SS) patients by flow cytometry can be difficult due to overlapping immunophenotypes with normal T cells using standard markers. We assessed the utility of programmed death-1 (PD-1/CD279), a transmembrane protein expressed in some hematopoietic cells, for identification and quantitation of circulating Sezary cells among established markers using flow cytometry.
50 MF/SS and 20 control blood samples were immunophenotyped by flow cytometry. Principal component analysis (PCA) assessed contributions of antigens to separation of abnormal from normal T cell populations. PD-1 was assessed over time in blood and bone marrow of available MF/SS cases.
Normal CD4+ T cells showed dim/intermediate to absent PD-1 expression. PD-1 in Sezary cells was informatively brighter (≥1/3 log) than internal normal CD4+ T cells in 39/50 (78%) cases. By PCA, PD-1 ranked 3rd behind CD7 and CD26 in population separation as a whole; it ranked in the top 3 markers in 32/50 (64%) cases and 1st in 4/50 (8%) cases when individual abnormal populations were compared to total normal CD4+ T cells. PD-1 clearly separated Sezary from normal CD4+ T cells in 15/26 (58%, 30% of total) cases with few and subtle alterations of pan-T cell antigens/CD26 and was critical in 6 (12% of total), without which identification and quantification were significantly affected or nearly impossible. PD-1 remained informative in blood/bone marrow over time in most patients.
PD-1 significantly contributes to accurate flow cytometric Sezary cell assessment in a routine Sezary panel.
由于使用标准标志物时，蕈样真菌病/Sezary 综合征 (MF/SS) 患者外周血中的 Sezary 细胞与正常 T 细胞的免疫表型重叠，因此通过流式细胞术准确检测 Sezary 细胞可能具有挑战性。我们评估了程序性死亡受体-1 (PD-1/CD279) 的效用，PD-1 是一种在某些造血细胞中表达的跨膜蛋白，用于在流式细胞术中使用既定标志物鉴定和定量循环中的 Sezary 细胞。
对 50 例 MF/SS 和 20 例对照血液样本进行流式细胞术免疫表型分析。主成分分析 (PCA) 评估了抗原对异常 T 细胞群体与正常 T 细胞群体分离的贡献。对可用 MF/SS 病例的血液和骨髓进行 PD-1 的时间评估。
正常 CD4+T 细胞显示出弱/中等到无 PD-1 表达。在 39/50（78%）例中，Sezary 细胞中的 PD-1 明显比内部正常 CD4+T 细胞亮（≥1/3 个对数）。通过 PCA，PD-1 在整体人群分离方面仅次于 CD7 和 CD26，排名第 3；在 32/50（64%）例中排名前 3 标志物，在与总正常 CD4+T 细胞比较时 4/50（8%）例中排名第 1。PD-1 可在 15/26（58%，占总例数的 30%）例具有少量和细微的 T 细胞抗原/CD26 改变的情况下，将 Sezary 细胞与正常 CD4+T 细胞明显分离，在没有 PD-1 的情况下，鉴定和定量受到显著影响或几乎不可能。在大多数患者中，PD-1 在血液/骨髓中随时间推移仍具有信息性。
PD-1 显著有助于常规 Sezary 面板中准确的流式细胞术 Sezary 细胞评估。
