FACS analysis-a new and accurate tool in the diagnosis of lymphoma in the cerebrospinal fluid

Assessment of the Utility of Cytology and Flow Cytometry of Cerebrospinal Fluid Samples in Clinical Practice

OBJECTIVES

We sought to assess the utility and limitations of both flow cytometry (FC) and cytology for the analysis of cerebrospinal fluid (CSF) in a practical clinical setting.

METHODS

A total of 393 consecutive CSF samples from 171 patients submitted for both cytomorphologic and FC assessments were analyzed.

RESULTS

Both FC and cytology findings were negative for malignancy in 315/393 samples (80%), and either positive (POS) or suspicious/atypical (SUSP/AT) in 7% of samples. This resulted in high agreement between FC and cytology (87%). Minor discrepancies were present in 4% of the cases. In 28 samples, an abnormal population was detected by FC but not by cytology.

CONCLUSIONS

FC and cytology are important complementary methods for analyzing CSF samples. In cases where cytology is SUSP/AT and FC is inconclusive or negative, additional specimens should be submitted for immunostaining, cytogenetics, and/or molecular studies.

Single-Cell Proteomics for Cancer Immunotherapy

Cancer immunotherapy fights against cancer by modulating the immune response and is delivering encouraging results in clinical treatments. However, it is challenging to achieve durable response in all cancer patients during treatment due to the diversity and dynamic nature of immune system as well as inter- and intratumor heterogeneity. A comprehensive assessment of system immunity and tumor microenvironment is crucial for effective and safe cancer therapy, which can potentially be resolved by single-cell proteomic analysis. Single-cell proteomic technologies enable system-wide profiling of protein levels in a number of single cells within the immune system and tumor microenvironment, and thereby provide direct assessment of the functional state of the immune cells and tumor-immune interaction that could be used to evaluate efficacy of immunotherapy and to improve clinical outcome. In this chapter, we summarized current single-cell proteomic technologies and their applications in cancer immunotherapy.

On-chip cell sorting by high-speed local-flow control using dual membrane pumps

Although researchers have proposed various methods of on-chip cell sorting, high-throughput sorting of large cells remains hampered by the difficulty of controlling high-speed flow over a wide sorting area. To overcome this problem, we proposed high-speed local-flow control using dual membrane pumps driven by piezoelectric actuators placed on the outside of a microfluidic chip in this paper. We evaluated the controllability of shifting the flow profile by the local-flow. The results indicated that we could sort large cells up to approximately 150 μm in size with an equivalent throughput of 31 kHz. Because our method can control the flow profiles, it is applicable not only to large cells but also to small cells. The cell-sorting efficacy of the proposed method was experimentally evaluated on Euglena gracilis NIES-48 (E. gracilis) cells as large target cells and GCIY-EGFP (GCIY) cells derived from a gastric cancer cell line as small target cells. In E. gracilis cells sorting, the throughput is 23 kHz with a 92.8% success rate, 95.8% purity, and 90.8% cell viability. In GCIY sorting, the throughput is 11 kHz with a 97.8% success rate, 98.9% purity, and 90.7% cell viability. These results confirm that the proposed method sorts differently sized cells with high throughput and hence, overcomes the throughput-size trade-off that exists in conventional on-chip cell sorters.

Accuracy of flow cytometry and cytomorphology for the diagnosis of meningeal involvement in lymphoid neoplasms: A systematic review

Central nervous system (CNS) involvement by lymphoid neoplasms is a relatively infrequent event that demands accurate identification. The purpose of this article is to review studies comparing diagnostic accuracy of flow cytometry (FCM) and cytomorphology (CM) for meningeal involvement from lymphoid neoplasms. Primary publications from the last 26 years were identified searching MedLine, Scopus, and Web of Science and systematically scanning bibliographies of identified articles. Only studies reporting complete results were included. We assessed study quality using the QUADAS-2 tool. For each study, we extracted informations regarding study population, technical details about sample preparation, data analysis, and results. Twenty-seven studies were included. A great heterogeneity regarding study populations and analytical procedures was observed among studies. Percentages of samples giving a positive result with both FCM and CM range from 0.3% to 42.9% among studies, whereas double negative samples go from 0% to 96.3%. Samples with positive FCM but negative CM are reported by 89% (24/27) of the studies with rates ranging from 3.5% to 61.5% of total specimens. On the contrary, samples with positive CM and negative FCM are found in 48% (13/27) of the studies with percentages ranging from 0.5% to 10%. Despite all the differences observed among studies, almost all of them state that employing flow cytometry along with conventional cytology increases the number of positive CSF samples for lymphoma involvement, although a few cases remain in whom only morphology can correctly identify malignant cells. Diagn. Cytopathol. 2016;44:841-856. © 2016 Wiley Periodicals, Inc.

Renoprotective effect of Linum usitatissimum seeds through haemodynamic changes and conservation of antioxidant enzymes in renal ischaemia-reperfusion injury in rats

Objective

To evaluate an ethanolic extract of seeds of Linum usitatissimum (Linn.) (EELU) for its renoprotective role in rats through its antihypertensive effect and conservation of biological oxidation enzymes.

Materials and methods

Male Wistar rats (200–250 g) underwent uninephrectomy on day 0; after 2 weeks of recovery, the nephrectomised rats were divided into four groups of eight each: (I) sham (II); renal ischaemia reperfusion (RIR); (III) RIR + EELU 200 mg/kg; and (IV) RIR + EELU 400 mg/kg. In group II, III and IV the renal artery was occluded for 45 min and reperfused for 4 weeks; the sham group did not undergo RIR.

Results

EELU (400 mg/kg) significantly decreased the haemodynamic changes after 4 weeks of RIR injury. EELU treatment significantly restored the levels of renal endogenous antioxidant enzymes and membrane-bound enzymes. EELU 400 mg/kg restored the levels of blood urea nitrogen and serum creatinine. EELU also decreased the levels of tumour necrosis factor-α and myeloperoxidase activity. A flow-cytometric study confirmed a significant decrease in cellular necrosis and increase in viability after RIR in EELU-treated rats. The anti-apoptotic role of EELU was evident from the decrease in DNA fragmentation. Renal tissue damage as assessed by histopathology was decreased in groups III and IV (200 and 400 mg/kg EELU).

Conclusion

We conclude that EELU protected the kidney against RIR-induced renal injury, probably by inhibiting reactive oxygen species that have a causal role in such cases. It also inhibits apoptotic cell death and inflammation, and improves haemodynamic changes.

Hepatoprotective, immunomodulatory, and anti-inflammatory activities of selenocystine in experimental liver injury of rats

The study was evaluated to investigate the efficacy of selenocystine (CysSeSeCys), a well-known organoselenium compound, on the prevention of carbon tetrachloride (CCl(4))-induced acute hepatic injury in Wistar rats. Forty healthy male Wistar rats were utilized in this study. Acute hepatotoxicity was induced by CCl(4) intoxication in rats. Serum biological analysis, oxidative stress, immune parameters, and gene expression of COX-2 and CYP2E1 were carried out. Pretreatment of CysSeSeCys prior to CCl(4) administration significantly prevented an increase in serum hepatic enzymatic activities. In addition, pretreatment of CysSeSeCys significantly prevented the formation of ROS, MDA, depletion of glutathione, and alteration of antioxidant enzyme activities in the liver of CCl(4)-intoxicated rats. This study also revealed that pretreatment with CysSeSeCys normalized the levels of interleukin 6 and10, IgG, and CD4 cell count. Pretreatment of CysSeSeCys significantly reversed COX-2 inflammatory response and the upregulation of CYP2E1 expression as well. Histopathological changes induced by CCl(4) were also significantly attenuated by CysSeSeCys pretreatment. CysSeSeCys has a potent hepatoprotective effect on CCl(4)-induced liver injury in rats through its antioxidative, immunomodulatory and anti-inflammatory activity.

Flow cytometry and cytomorphology evaluation of hematologic malignancy in cerebrospinal fluids: comparison with retrospective clinical outcome

An independent clinical assessment was compared with flow cytometry (FCM) and cytomorphology results obtained on 227 cerebrospinal fluids investigated for hematologic malignancy, in a retrospective longitudinal study with a median observation time of 11 months. A combined method assessment (CMA), defining "positive" a sample if at least one method gave "positive" results, was also tested. Eleven out of 55 screening samples and 53 out of 166 follow-up samples resulted positive at clinical evaluation. FCM and CM were concordant with positive clinical assessment in 68.5% and 51.5% of cases, respectively. According to CMA, 10.5% of samples (resulting false negative by either FCM or cytomorphology) were rescued as true positive. FCM retained significantly higher accuracy than cytomorphology (p=0.0065) and 100% sensitivity when at least 220 leukocytes were acquired. CMA accuracy was higher than FCM accuracy and significantly higher than cytomorphology accuracy in the analysis of all samples (p<0.0001), samples from mature B/T cell neoplasms (p=0.0021), and samples drawn after intrathecal treatment (p=0.0001). When acquiring ≤220 leukocytes, FCM accuracy was poor, and combining cytomorphology added statistically significant diagnostic advantage (p=0.0043). Although FCM is the best diagnostic tool for evaluating CSF, morphology seems helpful especially when clinically positive follow-up samples are nearly acellular.

Flow cytometric immunophenotyping of cerebrospinal fluid specimens

Flow cytometric immunophenotyping (FCI) is recommended in the evaluation of cerebrospinal fluid (CSF) specimens for hematologic neoplasms. This study reviewed FCI of CSF specimens collected for primary diagnosis (n = 77) and follow-up for known malignancy (n = 153). FCI was positive in 11 (4.8%) of 230 specimens: acute myeloid leukemia, 6; precursor B-acute lymphoblastic leukemia, 2; B-cell lymphoma, 2; and T-cell lymphoma, 1. Positive results were obtained in low-cellularity specimens, including 2 with fewer than 100 events in the population of interest. FCI was indeterminate in 19 (8.3%) of 230 specimens, including 3 with only sparse events, 8 with possible artifact (apparent lack of staining, nonspecific or background staining, and aspirated air), and 8 with phenotypic findings considered insufficient for diagnosis. Indeterminate specimens were often limited by low cellularity and lacked normal cell populations to evaluate for appropriate staining. FCI may be of value in low-cellularity CSF specimens, although the results should be interpreted with caution.

Antibacterial and ulcer healing effects of organoselenium compounds in naproxen induced and Helicobacter pylori infected Wistar rat model

Aim of the present study was to evaluate in vitro toxicity and in vivo antibacterial, anti-inflammatory, antiulcer, and antioxidant activities of two organoselenium compounds, selenocystine (SeCys) and ebselen (Ebs). The study was conducted in experimentally induced ulcers in rodent model infected with Helicobacter pylori (H. pylori). In vitro toxicological studies on normal splenic lymphocytes revealed that SeCys and Ebs were non-toxic to the cells even at 100 μM concentration. Antibacterial activity was observed at 500 μg/mL concentration of either of the compounds against H. pylori. In vivo studies after treatment with SeCys and Ebs (500 μg/kg/day) resulted in significant reduction in ROS production and inhibition of lipid peroxidation in gastric tissue. The antioxidant and anti-inflammatory activities of both the compounds were also confirmed by their ability to lower GSH reduction, to induce the expression of antioxidant genes such as GPx-4, and MnSOD and to suppress inflammatory genes namely COX-2, TNF-α and TGF-β. In addition, the immunomodulatory activity of both the compounds was evident by enhance of the CD4 levels and maintenance of the IgG, IL-6 and IL-10 levels. Persistent treatment (500 μg/kg, for 28 days) with both the compounds showed considerable (p<0.05) ulcer healing property supporting its role in gastro protection. In conclusion, the results of our study suggest that both SeCys and Ebs possess broad spectrum of activities without any potential toxicity.

Immunophenotyping and immunoglobulin heavy chain gene rearrangement analysis in cerebrospinal fluid of pediatric patients with acute lymphoblastic leukemia

The study aimed to assess the diagnostic accuracy of Flow cytometry (FCM) immunophenotyping and IgH gene rearrangements (IGHRs) by real-time PCR in comparison with classic cytology for diagnosing CNS infiltration in pediatric ALL. We concluded that the diagnostic value of FCM and IGHR are two to three times more than that of cytology. Therefore, immunophenotyping by FCM is recommended for routine diagnosis of CSF infiltration. Furthermore, IGHR analysis by real-time PCR appears to be a useful addition in evaluation of CNS infiltration.

Syndrome de Garcin révélant un lymphome malin non hodgkinien

INTRODUCTION

R Garcin described progressive unilateral cranial nerve palsy in 1926. Garcin syndrome is characterized by progressive involvement of the cranial nerves culminating in total unilateral paralysis of all cranial nerves. Carcinoma of the skull base or ENT regions is the most common etiology.

CASE REPORT

A 74-year-old man developed signs involving the left Vth (V2 and V3) cranial nerve then the VIth, VIIth and VIIIth cranial nerves and finally the IXth and Xth. MRI showed involvement of these cranial nerves with gadolinium uptake and involvement of the pons at the terminal phase. Careful ENT explorations failed to reveal a cause. The lymphocyte count was elevated in the cerebrospinal fluid. The patient died one year after diagnosis and the general autopsy was normal. The neuropathological studies led to the post-mortem diagnosis of type B non-Hodgkin lymphoma.

CONCLUSION

In patients with Garcin syndrome, lymphoma is a possible diagnosis when carcinoma of the ENT regions or of the skull bases are not present.