Seminario molecular
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Monitoring Residual MyelomaHigh-Resolution Serum/Urine Electrophoresis or Marrow
Biopsy With Immunohistochemical Analysis?
Vanessa Agudelo Vásquez ID: 000170813
María Mercedes Barros Daza ID: 000170833
3rd Semester
Medicine
Amanda D. Tatsas, MD, Madan H. Jagasia, MBBS, MS, Heidi Chen, PhD, and Thomas L. McCurley, MD.
American Society for Clinical Pathology
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INTRODUCTION
MARROW BIOPSY
A bone marrow biopsy is the removal of soft tissue, called marrow, from inside bone. Bone marrow is found in the hollow part of most bones. It helps form blood cells.
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ELECTROPHORESIS
Electrophoresis is a separations technique that is based on the mobility of ions in an electric field.
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IMMUNOHISTOCHEMICAL ANALYSIS
Structural and morphological studies of tissues.
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GENERAL OBJETIVE
This study to compare the detection of residual MM in BM biopsy specimens with immunoperoxidase staining with noninvasive studies by SPE and UPE in routine patient follow-up and show that SPE and UPE are sensitive and effective methods to detect residual disease, and negative results for both can obviate the need for a BM biopsy.
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MATERIALES Y METODOS
83 Biopsias: Mayo 2006 a
Diciembre 2006
47 Hombres 36 Mujeres
EM: 53 años Tiempo transcurrido: 561 días (rango, 17-2,750 días)
Muestra
RESULTADO
•SPE•UPE•Médula ósea
•Ig monoclonal pesada
•Cadenas ligeras (K – L)
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INMUNOHISTOQUIMICA: Identificación de un tejido por medio de la interacción de un antígeno con un anticuerpo (marcado). La célula se colorea para demostrar la relación y localización de un molécula de interés.
INMUNOFIJACIÒN: Es una técnica de laboratorio que se utiliza para identificar proteínas o anticuerpos en la sangre, suero y orina.
MATERIALES Y METODOS
CP: Cadenas pesadas (G- A- M – D – E)
Cadenas ligeras: (K- L)
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•Diagnóstico de la SPE MM: PSE y UPE para cada paciente.
•Posterior al diagnóstico: UPE en el momento de la biopsia de seguimiento para el monitoreo de Mieloma múltiple.
células plasmáticas con CD138 (Syndecan-1)
Manchas κ y λ en la cadena ligera
MATERIALES Y METODOS
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MATERIALES Y METODOSMétodos
•Las manchas H & E y de histoquímica fueron revisadas por (2) patólogos (ADT y TLM)
•Se utilizó la plataforma DAKO para el análisis inmunohistoquímica de BM, κ, λ, y CD138
•Técnicas del sistema de inmunofijación Helena SPIFE .
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RELACION
INMUNOHISTOQUIMICA
65 casos de análisis inmunohistoquímica con células plasmáticas con
CD138 (Syndecan-1)
INMUNOFIJACIÒN
Manchas κ y λ en la cadena ligera
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RESULTADOS
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RESULTADOS
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IMAGEN 1: UPE
RESULTADOS
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Conclusión: El método UPE no invasivo ( sedimento urinario) es igual de efectivo a la biopsia que es invasivo.
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IMAGEN 2: SPE
RESULTADOS
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Conclusión: La técnica no invasiva de análisis del suero, es mas efectiva porque detectó en mayor cantidad las proteínas monoclonales que lo detectado por inmunohistoquímica con los CD138 en la biopsia de medula ósea.
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AUTHOR SAID YES OR NOT
Rasmussen T, et al. A variety of methods for monitoring disease activity are
available.
yes
Owen RG et, al. The use of multiple consensus primers allows detection of a clone in 80% of patients but
increases cost.
yes
Jaskowski TD et, al. κ and λ FLC assays are more sensitive than IFX but are less
specific.
yes
Catrou PG, May TA et, al.
Because the money spent on health care in the United States increases exponentially, cost-
effectiveness is becoming increasingly important to the
practice of health care.
yes
DISCUSSION
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1. The use of Immunohistochemical techniques generate changes in the physiology of conception and health and disease.
3. The analysis obtained by the interaction of antigen and antibody allows a firm diagnosis of MM.
5. For the diagnosis of multiple myeloma, non-invasive techniques exist to facilitate the knowledge of the results without painful procedures to patients.
4. These studies contribute to the diagnosis currently effective, timely and accurate cancer, possibly reducing deaths.
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MAPA CONCEPTUAL : Vanessa Agudelo Vásquez
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MAPA CONCEPTUAL : María Mercedes Barros Daza
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