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[白血病免疫分型] TdT

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发表于 2011-11-28 22:59:51 | 显示全部楼层 |阅读模式
悬赏1流星未解决
最近在做TdT检测,可是透膜剂的选择很头疼,用COULTER的太柔和了,根本打不破细胞核。BD的太强了,细胞分群太差了,有时候会找不到白血病细胞。后来用的是COULTER做DNA的透膜剂,不加CD45,因为病人恶性细胞比例已经达到90%以上了,可以认为全是白血病细胞了。可最后结果是阴性,TdT在B-ALL的表达率还是很高的,也不知道这个阴性是真假。请教各位同仁做TdT的经验和心得。

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发表于 2011-11-29 10:26:15 | 显示全部楼层
关于TdT,flow cytometry in hematopathology一书中有段话很值得我们认真读读:
TdT: Reactivity with either TdT or CD34 indicates that the neoplasm is composed of immature
cells. Therefore, testing for TdT may be omitted for maturity assessment if the leukemia is already CD34+. TdT testing is most appropriate when the results from the standard panels indicate a lymphoid neoplasm with no CD34, no surface light chain expression, and no evidence of plasma cell differentiation. In that case, TdT is necessary to establish the maturity status of the tumor cells, which affects the diagnosis and therapy.
A useful approach to assess TdT in ALL is to combine the TdT assay with DNA analysis. Aneuploidy is not only helpful as a prognostic marker but the TdT/DNA combination will also serve as a useful fingerprint for the detection of residual/relapsed
disease in the patient’s follow-up specimens.
Another approach to monitoring MRD of T-ALL or precursor B-ALL is the combination of TdT with T-cell (e.g., CD7, CD3) or B-cell (e.g., CD19, CD10) markers, respectively. The combination TdT/CD19 offers good discrimination between benign B-cell progenitors and residual/relapsed precursor B-ALL (see Section 3.5.2).
Whereas the immature neoplastic cells in ALL can be confused morphologically with mature neoplastic lymphoid cells in LPD/NHL, blasts in AML are morphologically distinctive from the maturing myeloid precursors. Therefore, testing for TdT in AML is not necessary irrespective of whether CD34 is expressed or not. The expression of TdT in AML is noncontributory for diagnostic and prognostic purposes. Furthermore, because of the high frequency of antigenic shift in AML, it is unlikely that TdT can be useful as a fingerprint at relapse.


至于TdT的破膜剂,我建议你可以试试foxp3的破膜剂(biolegend的),我做cyclin D1做的效果还不错,也是核内的。
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 楼主| 发表于 2011-11-29 22:54:01 | 显示全部楼层
谢谢指点,尝试中
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 楼主| 发表于 2011-11-29 22:59:34 | 显示全部楼层
老师,这本书在哪里可以找到?
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发表于 2011-11-30 08:23:49 | 显示全部楼层
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发表于 2012-6-8 11:36:09 | 显示全部楼层
niwanmao 发表于 2011-11-29 10:26
关于TdT,flow cytometry in hematopathology一书中有段话很值得我们认真读读:
TdT: Reactivity with eith ...

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