FLOW CYTOMETRIC MEASUREMENT OF PROLIFERATION-ASSOCIATED NUCLEAR ANTIGEN P105 AND DNA CONTENT IN IMMUNO-PROLIFERATIVE SMALL-INTESTINAL DISEASE (IPSID)

Immunoproliferative small intestinal disease (IPSID), most common in M editerranean countries, is characterized by lymphomatous infiltration of the small intestine and is usually associated with the synthesis of anomalous immunoglobulin alpha heavy chains. Flow cytometric analysis of DNA content, S phase fraction, and quantitative analysis of the pr oliferation-associated nuclear antigen, P105, were performed in 23 pat ients with IPSID to determine if they could be used as prognostic indi cators in this disease. Eighteen patients had low-grade, two had inter mediate-grade, and three had high-grade lymphoma. Eight patients had c linical stage IE disease, 12 had stage IIE, and three had stage IIIE d isease. Eleven patients survived >5 yr (good prognosis),four survived between 2-5 yr (intermediate prognosis), and eight survived 2 yr or le ss (poor prognosis). The S phase fraction of patients with poor progno sis was significantly higher than those with intermediate or good prog nosis (P < 0.004). Flow cytometric evaluation of S phase fraction may offer important prognostic information in patients with IPSID and coul d be useful in the clinical management of patients with this highly va riable clinical syndrome. Further studies evaluating the value of DNA flow cytometry in larger groups of patients with IPSID are warranted. (C) 1995 Wiley-Liss, Inc.