流式细胞术检测B淋巴细胞表面免疫球蛋白轻链及临床意义

Surface immunoglobulin light-chain expression on B lymphocytes in neoplastic B-cell disorders and in non-neoplastic B-cell disorders

目的探讨流式细胞术检测外周血B淋巴细胞表面免疫球蛋白(Ig)轻链的实验方法和临床意义。方法采用流式细胞术,以CD19设门,分析了20例健康对照者和13例淋巴瘤患者B细胞表面Igkappa与lambda型轻链的表达。结果对照组kappa型轻链阳性B细胞为(51.4±5.2)%,lambda型轻链阳性B细胞为(39.2±4.3)%,两型轻链B细胞之比值为1.31±0.28;淋巴瘤患者B细胞中kappa型轻链8例(61.5%),lambda型轻链5例(38.5%),两型轻链B细胞的比值或者均小于0.01,或者大于56.78,显著超出健康人比值范围。结论流式细胞术直接检测B细胞表面kappa轻链与lambda轻链的表达有助于鉴别反应性B淋巴细胞增生和肿瘤性慢性B淋巴细胞增生。

Objective To establish a method for detection of surface immunoglobulin light-chain expression on B lymphocytes by flow cy- tometry, and to explain its clinical significance. Methods The immunoglobulin light-chain kappa and lambda in CD19 positive cells were detected in 20 healthy persons and 13 patients with neoplastic B-cell disorders by flow cytometry. Results The percentage of kappa^＋ B cell was 51.4 ± 5.2% and the percentage of lambda ＋ B cells was 39.2 ± 4.3%. The ratio of kappa/lambda was 1.31 ± 0.28 in healthy persons but it is more than 56.78 or less than 0.01 in patients with neoplastic B-cell disorders. In all the neoplastic patients, percentage of patients with type kappa was 61.5% and type lambda was 38.5%. Conclusion The detection of kappa light-chain or lambda light-chain on B lymphocytes was especially useful for distinguishing B-cell malignancy from reactive lymphadenopathy or non-B cell malignancy.