Analysis of Cerebrospinal Fluid Cells by Flow Cytometry and Immunocytochemistry in Inflammatory Central Nervous System Diseases: Comparison of Low‐ and High‐Density Cell Surface Antigen Expression

Abstract

The examination of cerebrospinal fluid (CSF) continues to play an important role in the diagnosis of inflammatory diseases of the central nervous system (CNS

Flow cytometric characterization of cerebrospinal fluid cells

“…Alternatively, it is stated that this technique should only be used when CSF cytomorphology fails in patients with a strong suspicion of leptomeningeal metastases (22). Compared to flow cytometry, immunocytochemistry gave similar results in detection of highdensity surface markers, whereas for analysis of antigens that are expressed at low density immunocytochemistry may be more reliable in some applications (23). Since flow cytometry is used in the detection of central nervous system (CNS) involvement of hematological malignancies besides cytomorphological analysis, as discussed in the Applications of flow cytometry to study CSF section, immunocytochemistry has no major role anymore.…”

“…The detection rate of CSF involvement in hematological malignancies is up to 86% higher in flow cytometry than in conventional cytomorphological analysis (6,14,42-48; Table 2). Although it was previously suggested that this method may not be suitable in the evaluation of samples with low cellularity (23), it has been shown that CSF T lymphocytes, the predominant lymphocyte subset in CSF, can be reliably detected in samples with a cell count lower than 5 leukocytes/ll (46). Kleine et al (49) showed that precision of lymphocyte flow cytometry is high (coefficient of variance [CV] 10%) provided that a sufficient number of events has been acquired (50).…”

“…Also, differences in survival rate between different leukocyte subsets were observed: monocytes and granulocytes showed a more rapid cell loss than lymphocytes (9,34,85; Table 3). In flow cytometric analysis, selective cell losses may cause underestimation of cell counts (23). These errors can affect clinical decisions.…”

Presentaciones orales

“…Aunque se sabe que se trata de una técnica con gran especificidad, la citología convencional tiene una sensibilidad limitada y se estima que puede proporcionar hasta 20% a 60% de falsos negativos (2,3); además, con frecuencia, los resultados de los estudios citológicos son de difícil interpretación, al no permitir distinguir claramente entre linfocitos normales/reactivos y neoplásicos (2,4,5). Hoy se reconoce que el diagnóstico precoz de la enfermedad meníngea podría contribuir a mejorar notablemente la evolución de los pacientes con riesgo de recaída en el sistema nervioso central, ya que podrían beneficiarse de una terapia dirigida de forma específica a la enfermedad meníngea (6).…”