Westwood N B, Pearson T C
Division of Haematology, United Medical School, Guy's Hospital, London, UK.
Leuk Lymphoma. 1996 Sep;22 Suppl 1:95-103. doi: 10.3109/10428199609074366.
Clonogenic cultures support the proliferation of haemopoietic cells into colonies of differentiated progeny. Using these techniques it has been established that normal haemopoietic progenitors are dependent upon growth factors for their survival, proliferation and differentiation in vitro. However, progenitors from patients with polycythaemia vera (PV) generate erythroid colonies in cultures deprived of exogenous erythropoietin. These have been termed endogenous erythroid colonies (EEC). Recently, endogenous megakaryocytic colonies (EMC), those arising in assays without megakaryocyte growth factors, have been reported, particularly in patients with primary thrombocythaemia (PT). Many investigators have found an EEC positive culture to have 100% diagnostic specificity and sensitivity for PV. Similarly, EMC have been shown by some to be an unequivocal marker of PT. Accordingly, clonogenic assays for EEC and EMC have been advocated as diagnostic markers of PV and PT. However, the specificity of these assays is not universally attested to as there are some reports of EEC in patients with secondary polycythaemia and of EEC and EMC in normal subjects. Thus, for diagnostic use, EEC and EMC assays must be exhaustively validated for specificity using clinically appropriate controls. Furthermore, clonogenic culture techniques are not amenable to external quality assurance, are technically demanding and are unlikely to be available in most haematology laboratories. These considerations must be taken into account when assigning weighting to EEC and EMC assays as diagnostic criteria in myeloproliferative disorders.
集落形成培养支持造血细胞增殖形成分化后代的集落。利用这些技术已经确定，正常造血祖细胞在体外的存活、增殖和分化依赖于生长因子。然而，真性红细胞增多症（PV）患者的祖细胞在缺乏外源性促红细胞生成素的培养中能产生红系集落。这些被称为内源性红系集落（EEC）。最近，有报道称出现了内源性巨核细胞集落（EMC），即在没有巨核细胞生长因子的检测中出现的集落，尤其是在原发性血小板增多症（PT）患者中。许多研究者发现EEC阳性培养对PV具有100%的诊断特异性和敏感性。同样，一些研究表明EMC是PT的明确标志物。因此，EEC和EMC的集落形成检测被提倡作为PV和PT的诊断标志物。然而，这些检测的特异性并未得到普遍证实，因为有报道称继发性红细胞增多症患者出现EEC，正常受试者也出现EEC和EMC。因此，为用于诊断，EEC和EMC检测必须使用临床合适的对照进行特异性的全面验证。此外，集落形成培养技术不适合外部质量保证，技术要求高，而且大多数血液学实验室不太可能具备。在将EEC和EMC检测作为骨髓增殖性疾病的诊断标准进行权重分配时，必须考虑这些因素。
