FLow Cytometric Detection of Malignant Cells in Body Fluids

造血系统恶性肿瘤累及脑脊液（CSF）， 很难单独通过形态学来记录。“非典型”或“可疑”的诊断是 通常用于细胞数量少或形态不明确的情况。在一项研究中 比较单独的形态学与流式细胞术的形态学，我们证明了流式细胞术的作用。 细胞免疫分型在一系列肿瘤的诊断中是有用的 已知患有淋巴瘤或白血病且初步诊断为“非典型”或 “可疑”CSF使用形态学标准。流式细胞术单位评价了以下因素的作用： 流式细胞术在高分级B细胞患者分期和治疗中的应用 淋巴瘤我们通过流式细胞术和细胞学评估了 新诊断为侵袭性B细胞淋巴瘤并有中枢神经系统疾病风险的患者 系统（CNS）受累。流式细胞术鉴定了肿瘤克隆， 仅占脑脊液淋巴细胞总数的0.2%。流式细胞术检测到细胞学， 化学和细胞计数都失败了流式细胞术检测疾病为阴性 预后因素，现在提示对NCI方案的患者进行治疗干预。作为 根据研究结果，我们建议有侵袭性B治疗CNS受累风险的患者 细胞淋巴瘤通过流式细胞术进行分期CSF评估。多流式细胞术 实验室报告CSF样本分析的成功率低。流式细胞术单位， CCR、NCI、NIH开发了用于CSF流式细胞术分析的特殊方案， 高成功率。流式细胞术单位参加了一项国际共识， 会议，以确定最佳的方法流式细胞术分析的CSF。的共识 建议在当前的细胞计数方案中出版。

Involvement of the cerebrospinal fluid (CSF) by hematopoietic malignancies may be difficult to document by morphology alone. The diagnoses of "atypical" or "suspicious" is frequently used in cases with low numbers of cells or ambiguous morphology. In a study comparing morphology alone to morphology with flow cytometry, we demonstrated that flow cytometric immunophneotyping was useful in establishing a diagnosis of neoplasia in a series of patients with known lymphoma or leukemia and an initial diagnosis of "atypical" or "suspicious" CSF using morphologic criteria. The Flow Cytometry Unit evaluated the role of flow cytometric analysis in staging and management of patients with high grade B cell lymphomas. We assessed the cerebrospinal fluid (CSF) by flow cytometry and cytology in patients newly diagnosed with aggressive B-cell lymphomas and at risk for central nervous system (CNS) involvement. Flow cytometry identified neoplastic clones that constituted as little as 0.2% of total CSF lymphocytes. Flow cytometry detected involvement where cytology, chemistry and cell counts failed. Flow cytometric detection of disease was a negative prognostic factor and now prompts therapeutic intervention in patients on NCI protocols. As a result of the study we recommended that patients at risk for CNS involvement by aggressive B cell lymphoma undergo staging CSF evaluation by flow cytometry. Many flow cytometry laboratories report a low success rate in analysis of CSF specimens. The Flow Cytometry Unit, CCR, NCI, NIH developed special protocols for flow cytometric analysis of CSF that has led to a high success rate. The Flow Cytometry Unit participated in an international consensus conference to determine optimal methodology for flow cytometric analysis of CSF. The consensus recommendations are in press in Current Protocols in Cytometry.