Finn W G, Peterson L C, James C, Goolsby C L
Department of Pathology, Northwestern University Medical School, Chicago, Illinois, USA.
Am J Clin Pathol. 1998 Sep;110(3):341-6. doi: 10.1093/ajcp/110.3.341.
Immunophenotyping by flow cytometry has not been widely applied to cerebrospinal fluid (CSF) analysis. We attempted to optimize flow cytometric detection of malignant lymphoma in CSF samples by the routine use of 3- and 4-color flow cytometry, with specific selection of lymphoid cells by fluorescence vs 90 degrees light scatter gating. Thirty-six consecutive CSF samples were immunophenotyped by flow cytometry, and the results were compared with those of standard microscopic examination. Lymphoid events were adequate for analysis in 27 of the 36 samples. Each of the 9 unsuccessful samples was more than 24 hours old at analysis or contained fewer than 1 x 10(4) total cells (< or =1 cell/microL). Lymphoma was detected in 10 of the remaining 27 cases. Six lymphomas were detected by morphology and flow cytometry, 1 only by morphologic examination, and 3 only by flow cytometry. Therefore, the combination of flow cytometry and morphologic examination enhanced the detection by 43% over morphologic examination alone. Flow cytometry permitted the detection of lymphoid clones totaling less than 1% of total cells. Multicolor flow cytometry is a rapid and sensitive technique that enhances detection of lymphoma in paucicellular CSF samples. Given the great sensitivity of flow cytometry, future studies will be necessary to assess the significance of detecting small lymphoid clones in this setting.
流式细胞术免疫表型分析尚未广泛应用于脑脊液（CSF）分析。我们尝试通过常规使用三色和四色流式细胞术来优化CSF样本中恶性淋巴瘤的流式细胞术检测，通过荧光与90度光散射门控对淋巴细胞进行特异性选择。对36份连续的CSF样本进行流式细胞术免疫表型分析，并将结果与标准显微镜检查结果进行比较。36份样本中有27份的淋巴细胞事件足以进行分析。9份未成功的样本在分析时均超过24小时，或总细胞数少于1×10⁴个（≤1个细胞/微升）。在其余27例病例中有10例检测到淋巴瘤。6例淋巴瘤通过形态学和流式细胞术检测到，1例仅通过形态学检查检测到，3例仅通过流式细胞术检测到。因此，流式细胞术和形态学检查相结合比单独的形态学检查提高了43%的检测率。流式细胞术能够检测到占总细胞数不到1%的淋巴细胞克隆。多色流式细胞术是一种快速且灵敏的技术，可提高在少细胞CSF样本中淋巴瘤的检测率。鉴于流式细胞术的高灵敏度，未来有必要开展研究以评估在这种情况下检测小淋巴细胞克隆的意义。
