Clinical Utility of a Lymph Node Normal Range Obtained by Flow Cytometry

Bryan, Christopher; Eastman, P. J.; Conner, JB; Baier, K. A.; Durham, J.

doi:10.1111/j.1749-6632.1993.tb38799.x

Cited by 19 publications

(17 citation statements)

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“…A recent normal range presented by Bryan et al (58) ( Table 5) uses a wide variety of monoclonal antibodies and appears to be consistent with other published normal lymph node ranges. Self and colleagues ( 5 9 ) accurately pointed out that in the clinical lab, most specimens require distinguishing between reactive (hyperplastic) and neoplastic lymph nodes, thus a "normal" range of reactive nodes would, in fact, be the most useful in the clinical setting.…”

Section: Lymph Nodessupporting

confidence: 86%

Quality control in flow cytometry for diagnostic pathology: II. A conspectus of reference ranges for lymphocyte immunophenotyping

McCoy

Overton

1994

Cytometry

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Immunophenotyping, as many other clinical assays, is interpreted only in the context of reference values obtained from healthy control individuals. While the use of these reference values, or ranges, has been commonplace in the clinical flow cytometry laboratory for well over a decade, there has been little consensus in standardizing how these values should be obtained, analyzed, or expressed. This report reviews the variables to be considered in establishing reference ranges and statistical methods which can be used. Additionally, examples are given of previously published reference ranges for a variety of specimens often submitted for immunophenotyping. D

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Section: Lymph Nodessupporting

confidence: 86%

Quality control in flow cytometry for diagnostic pathology: II. A conspectus of reference ranges for lymphocyte immunophenotyping

McCoy

Overton

1994

Cytometry

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“…Four patients had SLNs containing isolated tumor cells (0.2 mm or smaller) detected by only IHC—these patients developed disease recurrence, supporting the clinical significance of IHC-only positive SLNs [6,7,29]. As in other studies, mesenteric nodes from patients with benign disease were used as comparisons, since axillary nodes are rarely excised for nonmalignant conditions [22–24]; immune profile of control nodes paralleled literature standards [23,24]. Importantly, new computer-based imaging techniques provided high-resolution image acquisition of the entire nodal surface.…”

Section: Discussionmentioning

confidence: 54%

Profile of Immune Cells in Axillary Lymph Nodes Predicts Disease-Free Survival in Breast Cancer

et al. 2005

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BackgroundWhile lymph node metastasis is among the strongest predictors of disease-free and overall survival for patients with breast cancer, the immunological nature of tumor-draining lymph nodes is often ignored, and may provide additional prognostic information on clinical outcome.Methods and FindingsWe performed immunohistochemical analysis of 47 sentinel and 104 axillary (nonsentinel) nodes from 77 breast cancer patients with 5 y of follow-up to determine if alterations in CD4, CD8, and CD1a cell populations predict nodal metastasis or disease-free survival. Sentinel and axillary node CD4 and CD8 T cells were decreased in breast cancer patients compared to control nodes. CD1a dendritic cells were also diminished in sentinel and tumor-involved axillary nodes, but increased in tumor-free axillary nodes. Axillary node, but not sentinel node, CD4 T cell and dendritic cell populations were highly correlated with disease-free survival, independent of axillary metastasis. Immune profiling of ALN from a test set of 48 patients, applying CD4 T cell and CD1a dendritic cell population thresholds of CD4 ≥ 7.0% and CD1a ≥ 0.6%, determined from analysis of a learning set of 29 patients, provided significant risk stratification into favorable and unfavorable prognostic groups superior to clinicopathologic characteristics including tumor size, extent or size of nodal metastasis (CD4, p < 0.001 and CD1a, p < 0.001). Moreover, axillary node CD4 T cell and CD1a dendritic cell populations allowed more significant stratification of disease-free survival of patients with T1 (primary tumor size 2 cm or less) and T2 (5 cm or larger) tumors than all other patient characteristics. Finally, sentinel node immune profiles correlated primarily with the presence of infiltrating tumor cells, while axillary node immune profiles appeared largely independent of nodal metastases, raising the possibility that, within axillary lymph nodes, immune profile changes and nodal metastases represent independent processes.ConclusionThese findings demonstrate that the immune profile of tumor-draining lymph nodes is of novel biologic and clinical importance for patients with early stage breast cancer.

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“…[1][2][3][4] The abnormal profiles are compared to the pattern of cell marker expression normally seen in the organ/tissue being examined, and a diagnostic interpretation is made. While the normal reference ranges for differentiation antigens expressed by lymphoid cells from peripheral blood, bone marrow, and lymph nodes are well established, [11][12][13][14][15] there is little information concerning the immunophenotypic profile of lymphocytes found in normal or reactive spleen. The aim of our study was to provide a detailed immunophenotypic characterization of human spleen lymphocytes using three-and four-color flow cytometry.…”

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confidence: 99%

Flow cytometric analysis of normal and reactive spleen

Colovai

Giatzikis

et al. 2004

Modern Pathology

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Spleen is surgically removed for both non-neoplastic and neoplastic pathologies. A significant proportion of splenectomy specimens require distinguishing between reactive and neoplastic conditions (eg lymphoma). To establish a 'normal' reference range for the spleen lymphocyte subsets, fresh samples of benign, reactive spleens obtained from adult patients (N ¼ 12) and samples of normal spleen obtained from cadaveric transplant donors (N ¼ 14) were analyzed using three-and four-color flow cytometry. Study of pan-B, -T, and -NK marker expression revealed that the frequency of T cells is higher and that of B cells is lower in reactive (nonneoplastic) compared to normal (cadaveric) spleen. Furthermore, our study established a frame of reference for cell markers commonly used for immunophenotyping of lymphoma, and identified discrete lymphocyte subsets, such as early plasma cells and T cells carrying the phenotype of the NK/T subset. These results will facilitate an accurate interpretation of the flow cytometric analysis of human spleen lymphocytes.

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Clinical Utility of a Lymph Node Normal Range Obtained by Flow Cytometry

Cited by 19 publications

References 1 publication

Quality control in flow cytometry for diagnostic pathology: II. A conspectus of reference ranges for lymphocyte immunophenotyping

Quality control in flow cytometry for diagnostic pathology: II. A conspectus of reference ranges for lymphocyte immunophenotyping

Profile of Immune Cells in Axillary Lymph Nodes Predicts Disease-Free Survival in Breast Cancer

Flow cytometric analysis of normal and reactive spleen

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