title: Comparison of flow cytometric methods for the measurement of ZAP-70 expression in a routine diagnostic laboratory.
abstract: Chronic lymphocytic leukaemia (CLL) follows a variable clinical course with patient survival ranging from only a few years despite treatment, to several decades in patients who may never require clinical intervention. Determination of the mutational status of a patient's immunoglobulin heavy chain variable region (Ig V(H)) gene has been used to provide prognostic information, but this assay is not available in most laboratories. The discovery of the expression of the protein tyrosine kinase zeta-associated protein (ZAP)-70 in V(H)-unmutated CLL cases led to its proposal as a surrogate marker for V(H) status. This study investigated the measurement of ZAP-70 expression in CLL using different flow cytometric protocols. Two different antibodies and two different staining methods were compared. The Caltag ZAP-70 antibody and Fix & Perm kit were the easiest to use and were the most sensitive and specific combination, with 91% concordance between ZAP-70 expression and V(H) status. Three patients (9%) were discordant (two V(H) mutated/ZAP-70 positive, and one V(H) unmutated/ZAP-70 negative). No correlation existed between CD38 and either ZAP-70 expression or V(H) status. Measurement of ZAP-70 expression using the Caltag antibody/kit combination provides a standardized flow cytometric method that could be introduced into a routine CLL immunophenotyping panel in a clinical diagnostic laboratory.
authors.affiliation: Department of Haematology, Taunton & Somerset Hospital, Taunton TA1 5DA, Somerset, UK. graham.gibbs@tst.nhs.uk
authors.forename: G
authors.initials: G
authors.lastname: Gibbs
authors.forename: T
authors.initials: T
authors.lastname: Bromidge
authors.forename: D
authors.initials: D
authors.lastname: Howe
authors.forename: J
authors.initials: J
authors.lastname: Hopkins
authors.forename: S
authors.initials: S
authors.lastname: Johnson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019411:Clinical Laboratory Techniques; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007135:Immunoglobulin Variable Region / Q000235:genetics; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011505:Protein-Tyrosine Kinases / Q000032:analysis* / Q000235:genetics*; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D051746:ZAP-70 Protein-Tyrosine Kinase
chemical_list: D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region; D011933:Reagent Kits, Diagnostic; D011505:Protein-Tyrosine Kinases; D051746:ZAP-70 Protein-Tyrosine Kinase; C497261:ZAP70 protein, human