Flow Cytometric Analysis of Benign and Malignant Tumors

流式细胞术免疫分型是一种灵敏的良恶性肿瘤分析技术。我们正在研究该技术的改进及其在不同系统中诊断和测量预后标记物的应用。骨髓增生异常综合征（MDS）的特点是两岁或三岁发育不良。虽然MDS的诊断标准已经建立，但大量患者的血液和骨髓发现使得诊断和分类变得困难。流式细胞免疫分型是一种准确、高灵敏度的检测造血细胞定量和定性异常的方法。我们使用流式细胞术研究了直接MDS患者骨髓中的造血细胞群。这些结果与一系列再生障碍性贫血患者、正常供体和有完全缓解的非髓系肿瘤病史的患者的结果进行了比较。我们定义了与MDS相关的免疫表型异常，并比较了流式细胞术与形态学和细胞遗传学评估在困难病例中的诊断效用。虽然在大多数病例中形态学和细胞遗传学足以诊断，但当形态学和细胞遗传学结合不能诊断时，流式细胞术可以检测到免疫表型异常。我们的结论是，流式细胞术免疫表型可能有助于建立MDS的诊断，特别是当形态学和细胞遗传学不确定时。实验室一直对微小和残留淋巴瘤的检测感兴趣。我们正在使用多参数方法来提高单克隆b细胞群体检测的灵敏度，特别是在小样本中，如脑脊液。通过轻链检测肿瘤b细胞的抗原表达异常模式（如CD10， CD5, CD23, FMC7，或抗原表达强度异常），我们试图在混合多克隆b细胞中检测到极少数肿瘤b细胞。实验室正在研究各种淋巴瘤亚群的特异性流式细胞术标记物，以提高诊断准确性。

Flow Cytometric immunophenotyping is a sensitive technique for analysis of benign and malignant tumors. We are studying the refinement of this technique and its application to diagnosis and measurement of prognostic markers in different systems. The myelodysplastic syndromes (MDS) are characterized by bi- or trilineage dysplasia. Although diagnostic criteria are well established for MDS, a significant number of patients have blood and bone marrow findings that make diagnosis and classification difficult. Flow cytometric immunophenotyping is an accurate and highly sensitive method for detection of quantitative and qualitative abnormalities in hematopoietic cells. We used flow cytometry to study hematopoietic cell populations in the bone marrow of patients with straightforward MDS. The results were compared to those obtained in a series of patients with aplastic anemia, normal donors and patients with a history of non-myeloid neoplasia in complete remission. We defined the immunophenotypic abnormalities associated with MDS and compared the diagnostic utility of flow cytometry with morphological and cytogenetic evaluations in difficult cases. Although morphology and cytogenetics were adequate for diagnosis in the majority of cases, flow cytometry could detect immunophenotypic abnormalities in cases when combined morphology and cytogenetics were non-diagnostic. We conclude that flow cytometric immunophenotyping may help establish the diagnosis of MDS, especially when morphology and cytogenetics are indeterminate. The laboratory has an ongoing interest in detection of minimal and residual lymphoma. We are using multiparametric approaches to improve the sensitivity of detection of monoclonal B-cell populations, especially in small samples such as CSF. By targeting abnormal patterns of antigen expression (eg CD10, CD5, CD23, FMC7, or abnormal intensity of antigen expression) by neoplastic B-cells in light chain detection, we are attempting to detect very small numbers of neoplastic B-cells among admixed polyclonal B-cells. The laboratory is studying specific Flow Cytometric markers of various lymphoma sub-groups to improve diagnostic accuracy.