Gratama J W, Kraan J, Van den Beemd R, Hooibrink B, Van Bockstaele D R, Hooijkaas H
Department of Clinical and Tumor Immunology, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
Cytometry. 1997 Aug 15;30(4):166-77. doi: 10.1002/(sici)1097-0320(19970815)30:4<166::aid-cyto2>3.0.co;2-i.
Fifty-five laboratories participated in a send-out study of four peripheral blood samples comparing a standard protocol vs. local protocols for flow cytometric lymphocyte immunophenotyping. The standard protocol included centrally provided reagents, instrument setup using triple-fluorescent microbeads and a three-color, whole-blood immunostaining technique based on fluorescein isothiocyanate and phycoerythrin-labeled monoclonal antibodies, erythrocyte lysis, washing, fixation, and identification of nucleated cells by the DNA/RNA stain LDS-751. Data analysis guidelines included lymphocyte selection using CD45,CD14-assisted "backgating" on forward (FSC) and sideward (SSC) light scatter and placement of fluorescence (FL) markers on the basis of the isotype control staining. Most (i.e., 77%) of the variation in results of percentage lymphocyte subset assessments using the standard protocol was explained by laboratory, sample, background FL, and the interaction between laboratory and sample. Purity and completeness of the FSC,SSC lymphogate, background FL, flow cytometer type, and flow cytometer setup (which were either partly or entirely determined by laboratory) contributed significantly to the variation. The effect of the leukocyte differential count on the variation in absolute numbers of lymphocyte subsets was particularly large in lymphopenic samples. The use of this standard protocol vs. local protocols did not reduce the interlaboratory variation. Instrument incompatibility with the standard protocol (e.g., incompatible filter combinations for LDS-751 detection) and lack of experience of many participants with three-color flow cytometry (in particular with the use of LDS-751) may have contributed to that result. We suggest that training and experience in a universally applicable standard protocol are critical for minimization of interlaboratory variation in flow cytometric immunophenotyping.
55个实验室参与了一项对外周血样本的分发研究,该研究比较了流式细胞术淋巴细胞免疫表型分析的标准方案与本地方案。标准方案包括集中提供的试剂、使用三荧光微珠进行仪器设置以及基于异硫氰酸荧光素和藻红蛋白标记的单克隆抗体的三色全血免疫染色技术、红细胞裂解、洗涤、固定以及通过DNA/RNA染料LDS-751鉴定有核细胞。数据分析指南包括使用CD45选择淋巴细胞、基于前向(FSC)和侧向(SSC)光散射进行CD14辅助的“反向门控”以及根据同型对照染色放置荧光(FL)标记。使用标准方案进行淋巴细胞亚群百分比评估结果中,大部分(即77%)的变异可由实验室、样本、背景荧光以及实验室与样本之间的相互作用来解释。FSC、SSC淋巴细胞门的纯度和完整性、背景荧光、流式细胞仪类型以及流式细胞仪设置(部分或全部由实验室决定)对变异有显著贡献。在淋巴细胞减少的样本中,白细胞分类计数对淋巴细胞亚群绝对数量变异的影响尤为显著。与本地方案相比,使用该标准方案并未减少实验室间的变异。仪器与标准方案不兼容(例如,用于LDS-751检测的滤光片组合不兼容)以及许多参与者缺乏三色流式细胞术经验(特别是使用LDS-751)可能导致了这一结果。我们建议,在普遍适用的标准方案方面的培训和经验对于最小化流式细胞术免疫表型分析中的实验室间变异至关重要。