A Flow Cytometry Panel for Differential Diagnosis of Mantle Cell Lymphoma from Atypical B-Chronic Lymphocytic Leukaemia

Q2 Biochemistry, Genetics and Molecular Biology

Iranian Biomedical Journal Pub Date : 2023-01-01 DOI:10.52547/ibj.3275

Mahdieh Mehrpouri, Maryam Sadat Hosseini, Leila Jafari, Mohammad Mosleh, Eesmaeil Shahabi Satlsar

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引用次数: 1

Abstract

Background: Differential diagnosis of chronic lymphoproliferative disorders (CLDs) has remained challenging due to the highly variable morphology features and immunophenotyping. Currently, the development of multiple-marker panel analyses by flow cytometry has opened a broad way for diagnosis of CLDs.

Methods: We analyzed the peripheral blood and bone marrow samples of 131 patients with B-cell CLDs (including 91 chronic lymphocytic leukemia (CLL), 15 atypical CLL, 14 mantle cell lymphoma (MCL), and 11 CD5-/CD10-lymphoma patients) from April 2018 to April 2019, using a panel of specific markers by flow cytometry.

Results: Our results indicated that the expression pattern of CD22, CD23, FMC-7, and CD5 allowed us to accurately and differentially diagnose the B-CLL, MCL, and CD5-/CD10- lymphoma, while it was not capable of differentiating MCL from atypical CLL. We, however, found that the expression patterns of CD38 and immunoglobulin light chain differed significantly between atypical B-CLL and MCL. CD38 and lambda light chain were remarkably expressed in MCL patients (92.8% and 85%, respectively) compared to the atypical CLL (1.1% and 0% respectively), with the p value less than 0.001 for both markers. In contrast to MCL patients, all the patients with atypical CLL, expressed kappa light chain. The immunohistochemistry method used for cyclin D1 confirmed that the flow cytometry detection of kappa and lambda light chains could provide a new approach with high sensitivity (91%) and moderate specificity (50%) to distinguish MCL patients from atypical B-CLL.

Conclusion: Expression of CD5, CD20 (bright), CD22, FMC-7, CD38, and lambda light chain with no expression of CD23 can accurately detect MCL and differentiate it from atypical B-CLL

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流式细胞术鉴别诊断套细胞淋巴瘤与非典型b -慢性淋巴细胞白血病

背景:慢性淋巴细胞增生性疾病(CLDs)的鉴别诊断一直具有挑战性，因为其形态特征和免疫表型变化很大。目前，流式细胞术多标志物面板分析的发展为CLDs的诊断开辟了广阔的途径。方法:采用流式细胞术对2018年4月至2019年4月131例b细胞CLDs(包括91例慢性淋巴细胞白血病(CLL)、15例非典型CLL、14例套细胞淋巴瘤(MCL)和11例CD5-/ cd10 -淋巴瘤)患者的外周血和骨髓样本进行分析。结果:我们的研究结果表明，CD22、CD23、FMC-7和CD5的表达模式使我们能够准确和鉴别诊断B-CLL、MCL和CD5-/CD10-淋巴瘤，而不能区分MCL和非典型CLL。然而，我们发现CD38和免疫球蛋白轻链的表达模式在非典型B-CLL和MCL之间存在显著差异。CD38和lambda轻链在MCL患者中的表达(分别为92.8%和85%)显著高于非典型CLL患者(分别为1.1%和0%)，两者的p值均小于0.001。与MCL患者相比，所有非典型CLL患者均表达kappa轻链。细胞周期蛋白D1免疫组化方法证实，流式细胞术检测kappa和lambda轻链可为鉴别MCL患者和非典型B-CLL提供一种高灵敏度(91%)和中等特异性(50%)的新方法。结论:表达CD5、CD20(亮)、CD22、FMC-7、CD38和lambda轻链而不表达CD23可准确检测MCL并与非典型B-CLL鉴别

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