免疫淋巴细胞亚群分型在淋巴细胞恶性肿瘤筛查中的作用。

Cytometry Pub Date : 2000-02-15
R Thalhammer-Scherrer, M Veitl, M Exner, B Schneider, K Geissler, I Simonitsch, I Schwarzinger
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引用次数: 0

摘要

背景:外周血淋巴细胞亚群分型的主要诊断作用是区分恶性和反应性疾病。方法:本研究评估流式细胞术淋巴细胞亚群分型对淋巴细胞恶性肿瘤的筛查效果。用抗t -、B-和自然杀伤(NK)细胞单克隆抗体的组合分析了400个样本。结果:220份(55%)样本显示淋巴细胞亚群正态分布,73份(18%)样本显示淋巴细胞亚群非特异性改变,19份(5%)样本显示典型的eb病毒/巨细胞病毒(EBV/CMV)感染的反应性表型,88份(22%)样本表达淋巴瘤提示表型。淋巴瘤特异性表型最具预测性的独立因素是绝对淋巴细胞计数(P = 0.0001,优势比73.225)。结论:将流式细胞术淋巴细胞亚群分型作为淋巴瘤的诊断筛查方法,应局限于有或无形态异型的不明原因淋巴细胞绝对计数升高的病例,以及有明确淋巴瘤临床症状的病例。
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Role of immunological lymphocyte subset typing as a screening method for lymphoid malignancies in daily routine practice.

Background: The major diagnostic role of peripheral lymphocyte subset typing is to distinguish between malignant and reactive conditions.

Methods: The present study evaluates the screening efficacy of flow cytometric lymphocyte subset typing for the presence of a lymphoid malignancy. Four hundred samples were analyzed with a combination of anti-T-, B-, and natural killer (NK)-cell monoclonal antibodies.

Results: Two hundred and twenty (55%) samples showed a normal distribution of lymphocyte subsets, 73 (18%) samples exhibited unspecific alterations of lymphocyte subsets, 19 (5%) samples exhibited a reactive phenotype typical of Epstein-Barr virus/cytomegalovirus (EBV/CMV) infection, and 88 (22%) samples expressed a phenotype suggestive of lymphoma. The most predictive independent factor of a lymphoma-specific phenotype was the absolute lymphocyte count (P = 0.0001, odds ratio 73.225). Seventy-eight percent of samples containing >/=4 x 10(9)/l lymphocytes and 2% of samples with lymphocyte counts <4 x 10(9)/l exhibited a lymphoma-specific phenotype. The specificity of the referring clinical comment was the second best predictor of a lymphoma-specific typing outcome (P = 0.0001, odds ratio 19.589). The independent predictive values of lymphocyte morphology and of relative lymphocyte counts were of borderline significance.

Conclusions: The use of flow cytometric lymphocyte subset typing as a diagnostic screening method for lymphoma should be restricted to cases of unexplained elevation of absolute lymphocyte counts with or without morphological atypias and to cases with definite clinical symptoms of lymphoma.

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