Re: Interpretation of antigen expression

From: Bruce Davis (DAVISB@mmc.org)
Date: Sat Oct 13 2001 - 08:39:52 EST


Unfortunately there is little consensus on how to quantitate antigen expression.
Calibrations beads to convert relative fluorescence intensity (preferably median,
rather than mean) are one approach, such as MESF units.  In clinical practice I have
evolved to a rather simple approach of reporting antigen "density" in terms of +
(less than normal cell counterpart), ++ (similar to normal cell counterpart), and +++
(higher than normal cell counterpart).  For example, CLL is typically CD20+, being
less CD20 expression than seen on normal B cells, which would be defined as CD20++.
This approach does not require additional expense in beads and software and allows
for "corrections" between instrument types and PMT settings, as well as F/P ratio
differences between antibody clones.  However, I am the first to admit this is far
from universally accepted or used, but does circumvent the problems with the arbitrary
practice of quantify by the position on a log scale.  Another approach is to ratio
the fluorescence intensity to a reference bead or known cell population (Janis Giorgi
advocated using CD4 T cells).  This lack of consensus in quantitative cytometry is
increasingly becoming problematic, but is beginning to be addressed by the European
working group and efforts have also started by the Clinical Cytometry Society to drive
a scientifically based consensus definition.  So stay tuned.......

Regards,



Bruce H. Davis, M.D.
Maine Medical Center Research Institute
81 Research Drive
Scarborough, Maine  04074
USA

PHONE: 207-885-8113
FAX: 207-885-8110
Email:  davisb@mmc.org

>>> "LEE Wing-Keung" <wklee@ha.org.hk> 10/11/01 01:09PM >>>
Dear Flow-ers,

Could you kindly give some opinions on the following question?
1. What are the significants of quantitative analysis of antigen expression (e.g. for
those cases of immunophenotyping of malignant haematological diseases?
2. How /  What are the criteria to define the dim, intermediate or strong antigenic
expression? For example: dim for those overlapping the isotopic cutoff, intermediate
for those behind the isotopic cutoff and strong for those with 2 log scale of the
isotopic control.
 As coded in Haematologic 2001; 86:675-692, they suggested to use median fluorescence
 intensity (MFI). Any idea?

Best Regards,

W.K. LEE
United Christian Hospital,
Hong Kong, China.



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