Flow Cytometric Analysis of Benign and Malignant Tumors

流式细胞术单元通过以下方式为NCI临床方案提供广泛支持： 为接受NCI临床治疗的患者提供白血病和淋巴瘤的诊断检测 方案或进行测试以确定所述方案的合格性。流动 流式细胞术单位提供血液、骨髓、细针的临床流式细胞术评价 抽吸物、组织活检和体液用于NCI患者的血淋巴样瘤形成。的 由流式细胞术单元进行的大多数流式细胞术检测涉及检测 微小残留病（患者在治疗前在外部机构治疗后的状态） 根据NCI方案招募）和测量特定肿瘤细胞特征， 各种临床方案。该股的重大努力是致力于提供许多 商业实验室不提供的独特方案规定的测定。流动 细胞计数单位还积极参与国家卫生研究院工作人员和医学界的教育， 在医学实践中，流式细胞术的适当应用是很大的。流的效用 白血病和淋巴瘤的细胞计数分析在20世纪80年代后期获得认可。由于 随着时间的推移，临床流程领域的从业人员越来越关注 关于不一致的做法以及标准化和 验证及其对患者护理的可能影响。为了解决这个问题，一组美国和 加拿大血液病理学家、血液学家和实验室科学家在马里兰州贝塞斯达举行会议， 1995年11月16日至17日，开发美国-加拿大协商一致建议 流式细胞术分析血液肿瘤的免疫表型。共识文件 提供了关于实验室程序、数据 分析和解释以及数据报告。还提供了关于医疗保健的准则。 测试的适应症。虽然当时未能就数目或 用于白血病或淋巴瘤的流式细胞术评价的抗体的组合， 提供了用于选择抗体的策略和用于 提供了急性白血病和淋巴增生过程的鉴定。最近 人们日益认识到，需要为培训和教育制定标准， 流式细胞术领域的从业人员，包括技术人员、口译员和 实验室主任人们还认识到，以前的医疗适应症指南 流式细胞仪检测不再实用，新的医疗指南 基于临床体征和症状的流式细胞术分析适应症 提示血淋巴瘤形成。同样， 推荐用于出现特定体征和症状的患者的抗体组为 令人向往为了解决这些问题，流式细胞术单位，CCR，NCI，NIH组织了2006年 贝塞斯达流式细胞术免疫表型国际共识会议 血淋巴瘤。在这次会议期间，重要的问题和目标是 确定并定义一个结构，以实现所确定的目标。最后的共有 关于培训、医学适应症和该过程产生的抗体组的建议 于2007年9月出版。一个新的共识过程正在进行中，以确定最佳的 用于各种疾病过程的诊断抗体组。流式细胞术股参加了 在一个国际共识小组中， 血液淋巴瘤的脑脊液检查这一协商一致进程的结果 最近出版了。流式细胞术单位，CCR，NCI，NIH一直在帮助 制定淋巴瘤流式细胞免疫分型的规范性文件， 白血病，临床和实验室标准研究所。流式细胞术临床分析 肿瘤性血淋巴样细胞;批准指南-第二版。CLSI文件H43-A2。 本指南将作为实验室进行流式细胞术时的金标准 美国血液淋巴样恶性肿瘤的分析由CLIA/CAP检查。它 提供了流式细胞术中涉及的实验室程序的详细技术指南 血淋巴瘤的检查流式细胞术单位研究了免疫表型 家族性和散发性慢性淋巴细胞白血病的特征。家族性慢性 淋巴细胞白血病（CLL）家族正在研究，因为它们可能提供一个 研究CLL（一种常见肿瘤）发展的独特机会。我们研究了 散发性CLL和家族性CLL患者的免疫表型特征， 两组之间的显著差异。此外，预后与 家族性和散发性CLL的细胞表面蛋白质谱不同。

The Flow Cytometry Unit provides extensive support for NCI clinical protocols by providing diagnostic testing for leukemia and lymphoma in patient either on NCI clinical protocols or undergoing testing to determine eligibility for said protocols. The Flow Cytometry Unit provides clinical flow cytometric evaluation of blood, bone marrow, fine needle aspirates, tissue biopsies and body fluids for hematolymphoid neoplasia in NCI patients. The majority of flow cytometric testing performed by the Flow Cytometry Unit involves detection of minimal residual disease (patients are status post therapy at outside institution prior to enrollment on NCI protocol) and measurement of specific tumor cell characteristics mandated by various clinical protocols. Significant effort in the unit is devoted to delivery of numerous unique protocol mandated assays that are not offered by commercial laboratories. The Flow Cytometry Unit is also actively engaged in education of the NIH staff and medical community at large in the proper utility of flow cytometry in medical practice. The utility of flow cytometric analysis in leukemia and lymphoma gained acceptance in the late 1980s. Since that time there has been growing concern among practitioners in the field of clinical flow cytometry about inconsistent practices as well as deficiencies in standardization and validation and its possible impact on patient care. To address this issue a group of U.S. and Canadian hematopathologists, hematologists and laboratory scientists met in Bethesda, MD from November 16-17, 1995 to develop the U.S.-Canadian Consensus Recommendations on the Immunophenotypic Analysis of Hematologic Neoplasia by Flow Cytometry. The consensus document produced provided guidance on standardization and validation of laboratory procedures, data analysis and interpretation and data reporting. Guidelines were also provided on medical indications for testing. Although consensus could not be reached at that time on the number or combination of antibodies utilized in flow cytometric evaluation of leukemia or lymphoma, strategies were provided for the selection of antibodies and lists of markers useful in identification of acute leukemias and lymphoproliferative processes were provided. Recently there was growing recognition of the need to set standards of training and education for practitioners in the field of flow cytometry, including technologists, interpreters and laboratory directors. It was also realized that the previous guidelines on medical indications for flow cytometric testing were no longer practical and that new guidelines on medical indications for flow cytometric analysis that are based upon clinical signs and symptoms suggestive of hematolymphoid neoplasia are needed in the field. Similarly, guidelines on antibody panels recommended for patients presenting with specific signs and symptoms are desirable. To address these issues the Flow Cytometry Unit, CCR, NCI, NIH organized the 2006 Bethesda International Consensus Conference on Flow Cytometric Immunophenotyping of Hematolymphoid Neoplasia. During this conference the important issues and goals were identified and a structure defined to achieve the identified goals. The final consensus recommendations on training, medical indications and antibody panels generated by this process were published in September 2007. A new consensus process in underway to determine optimal diagnostic antibody panels for various disease processes. The flow cytometry Unit participated in an international consensus group determining optimal methodology for diagnostic evaluation of cerebral spinal fluid for hematolymphoid neoplasia. The results on this consensus process have recently been published. The Flow Cytometry Unit, CCR, NCI, NIH has been instrumental in producing the regulatory document on flow cytometric immunophenotyping of lymphoma and leukemia, Clinical and Laboratory Standards Institute. Clinical Flow Cytometric Analysis of Neoplastic Hematolymphoid Cells; Approved Guideline-Second Edition. CLSI document H43-A2 . This guideline will be used as the gold standard when laboratories performing flow cytometric analysis of hematolymphoid malignancies in the United States are inspected by CLIA/CAP. It provides detailed technical guidelines for laboratory procedures involved in flow cytometric testing of hematolymphoid neoplasia. The Flow Cytometry Unit has studied the immunophenotypic characteristics of familial and sporadic chronic lymphocytic leukemia. Familial chronic lymphocytic leukemia (CLL) families are being studied because they potentially provide a unique opportunity to study the development of CLL, a common neoplasm. We have studied the immunophenotypic profiles of patients with sporadic CLL and with familial CLL and found significant differences between the two groups. Furthermore, the association of prognosis with the cell surface protein profile differs between familial and sporadic CLL.