title: Flow cytometric detection of ZAP-70 in chronic lymphocytic leukemia: correlation with immunocytochemistry and Western blot analysis.
abstract: BACKGROUND
  Expression of ZAP-70 in chronic lymphocytic leukemia (CLL) predicts worse clinical outcome in patients with early-stage disease. It has become important to include ZAP-70 in the immunophenotyping panel used to diagnose CLL, commonly performed by flow cytometry (FC). Nevertheless, the methodology used to detect ZAP-70 by FC has not been extensively evaluated.
  
  
  OBJECTIVE
  To describe our FC method for detecting ZAP-70 in CLL and assess whether this assay is useful in estimating the ZAP-70 protein level in CLL cells.
  
  
  METHODS
  ZAP-70 expression was assessed by FC in 45 consecutive newly diagnosed CLL patients, and the results were correlated with those of immunocytochemistry and Western blot analysis.
  
  
  RESULTS
  With >25% ZAP-70-positive B cells as the cutoff, the FC results had a perfect concordance with those of immunocytochemistry (39/39, 100%) and Western blot analysis (7/7, 100%). The use of autofluorescence controls was found to be superior to other alternatives. Overall, 19 (42%) of 45 cases were ZAP-70 positive in our series. Since only 7 cases (16%) had >20% to 30% ZAP-70-positive B cells, the cutoff of >25% readily separated CLL into positive and negative groups in most cases. ZAP-70 positivity was significantly associated with atypical morphology but not other laboratory parameters evaluated.
  
  
  CONCLUSIONS
  With proper specimen processing and the use of directly fluorescence-conjugated anti-ZAP-70 antibody, one can readily incorporate ZAP-70 into the routine FC study panel for CLL. Our data suggest that FC is a rapid and useful method to estimate the ZAP-70 protein expression level in CLL.
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada.
authors.forename: Graham W
authors.initials: GW
authors.lastname: Slack
authors.forename: Juanita
authors.initials: J
authors.lastname: Wizniak
authors.forename: Laith
authors.initials: L
authors.lastname: Dabbagh
authors.forename: Xinzhe
authors.initials: X
authors.lastname: Shi
authors.forename: Pascal
authors.initials: P
authors.lastname: Gelebart
authors.forename: Raymond
authors.initials: R
authors.lastname: Lai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000276:immunology; D015153:Blotting, Western / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D005455:Fluorescent Antibody Technique / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D016130:Immunophenotyping / Q000379:methods; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013048:Specimen Handling; D051746:ZAP-70 Protein-Tyrosine Kinase / Q000276:immunology / Q000378:metabolism*
chemical_list: D000906:Antibodies; D051746:ZAP-70 Protein-Tyrosine Kinase