![]() A more quantitative method of expression is the DNA index (DI), which is the ratio of the mean tumor sample G0 /G1 DNA content of normal diploid reference cells. DNA aneuploid tumors have additional peaks on DNA histogram, presumably representing cells containing more or less nucleic acid than is found in 46 normal chromosomes. In such testing, DNA diploid tumors are those in which a single peak containing an amount of DNA similar to normal control cells is generated by flow cytometry. Using fluorescent dye that stains nucleic acids, flow cytometry methods have also been applied to measure nuclear deoxyribonucleic acid (DNA) content (ploidy) as a prognostic indicator of solid tumors based on the fact that malignant cells sometimes show abnormalities in total chromosome number and the frequency of these abnormalities generally increases with progression to higher-grade tumors. For example, lymphocytes can be separated into B- and T-cell categories the T-cells can be further phenotyped as helper/inducer, suppressor/cytotoxic, or natural killer cell types. Data are most often collected as a bar-graph histogram, which is then displayed visually as a densitometer tracing of the bar graph the concentration of cells in each bar appears as a separate peak for each cell category, with a peak height proportional to the number of cells in each bar of the bar graph. The basic technique involves passage of a monocellular stream of cells through a beam of laser light after cell surface antigens have been tagged with fluorescent monoclonal antibodies complex computerized instruments are then used to sort normal from abnormal cells and also subgroups of the same cell type. DNA flow cytometric proliferation analysis (S-phase fraction or % S-phase).Ploidy and Cell Proliferation Activity: Experimental IndicationsĪetna considers flow cytometry-derived DNA content (ploidy), or cell proliferative activity (S-phase fraction or % S-phase) experimental and investigational in any of the following cancers (not an all-inclusive list) because its effectiveness for these indications has not been established:Īetna considers ektacytometry medically necessary for the diagnosis of red blood cell (RBC) cytoskeleton and hydration disorders (e.g., hereditary spherocytosis, pyro-poikilocytosis, stomatocytosis, ovalocytosis, elliptocytosis and xerocytosis) when RBC morphology does not provide a clear diagnosis.Īetna considers measurement of an RBC adhesion index (e.g., Hypoxic BioChip Adhesion or Normoxic BioChip Adhesion) experimental and investigational for all indications because the effectiveness of this approach has not been established.īackground Flow cytometry is an emerging technique, which involves the separation, classification and quantitation of cell types by:.Note: This test is usually performed only once per tumor lifetime usually after a diagnosis has been made and before treatment is initiated. Therefore, Aetna considers flow cytometry-derived DNA content (ploidy), or cell proliferative activity (S-phase fraction or % S-phase) in any of the following localized cancers without metastatic disease medically necessary only when the obtained prognostic information will affect treatment decisions: Ploidy and Cell Proliferation Activity: IndicationsĪ National Institutes of Health consensus development conference concluded that measurement of flow cytometry-derived DNA content (ploidy), or cell proliferative activity (S-phase fraction or % S-phase) is not indicated for prognostic or therapeutic purposes in the routine clinical management of cancers.T-cell monitoring for HIV infection and AIDS.Post-operative monitoring of members who have undergone organ transplantation or.Paroxysmal nocturnal hemoglobinuria or.Myeloproliferative neoplasms, for workup of disease progression to advanced phase or transformation to AML or.Measurement of CD4/CD8 ratio from bronchiolar lavage fluid for diagnosis of sarcoidosis or.Immunophenotyping for leukemia, lymphoma, or myelodysplastic syndrome or.Hereditary spherocytosis, in persons with Coombs' negative hemolytic anemia or. ![]() Hereditary persistence of fetal hemoglobin (HPFH), in persons with unexplained increases in hemoglobin F or.B-cell monitoring for immunosuppressive disorders or. ![]()
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