VCS技术在急性白血病及其亚型判断中的应用评价  

Evaluation of VCS technology in diagnosis for acute leukemia and its subtypes

作　　者：金红[1] 杨肃文[1] 金春兰[1] 戴泽宁[1] 许海红[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院检验科,杭州310016

出　　处：《中华检验医学杂志》2010年第8期740-746,共7页Chinese Journal of Laboratory Medicine

摘　　要：目的 探讨LH750血细胞分析仪VCS技术在急性白血病及其亚型判断中的应用价值.方法 选取178例急性白血病患者,包括105例AGL、42例ALL、31例AMOL;同时选取151例非白血病对照者,包括粒系对照组86例、淋系对照组35例、单核系对照组30例.采用LH750血细胞分析仪的VCS技术对各组患者的外周血标本进行VCS参数检测.以显微镜镜检为标准,判断VCS技术检出幼稚细胞的能力;分析各组患者中性粒细胞各项VCS参数（MNV、MNV-SD、MNC、MNC-SD、MNS、MNS-SD）、淋巴细胞各项VCS参数（MLV、MLV-SD、MLC、MLC-SD、MLS、MLS-SD）、单核细胞各项VCS参数（MMV、MMV-SD、MMC、MMC-SD、MMS、MMS-SD）的差异和变化;并对AGL各亚型组间VCS参数的差异进行比较分析;通过观察白血病患者的VCS三维散点图,结合仪器阳性提示,判断VCS技术有效提示各系白血病的能力.结果 以显微镜镜检为标准,VCS技术识别幼稚细胞的敏感度为95.5%（170/178）,特异度为95.4%（144/151）.AGL组MNV、MNV-SD、MNC、MNC-SD值分别为224.40±23.37、37.40±12.31、145.80±7.93、24.79±5.18,均高于粒系对照组的169.96±11.50、29.21±5.27、133.30±5.50、10.62±4.09,差异有统计学意义（t值分别为16.832、5.148、5.735、19.953,P均＜0.01）,MNS值为122.90±6.35,低于粒系对照组的131.00±5.69,差异有统计学意义（t=-7.64,P＜0.01）;ALL组MLV、MLV-SD、MLC、MLS、MLS-SD值分别为97.60±13.40、22.35±7.94、110.00±4.60、77.60±19.00、20.61±3.30,高于淋系对照组的82.10±3.00、14.41±2.35、100.60±2.70、48.10±3.50、17.60±1.60,差异有统计学意义（t值分别为7.576、6.118、4.041、9.353、2.988,P均＜0.05）;AMOL组MMV、MMV-SD、MMC、MMC-SD、MMS值分别为197.30±20.50、30.47±6.58、123.20±10.10、6.57±1.57、98.00±5.60,高于单核系对照组的167.80±15.77、21.90±9.64、113.60±6.73、5.20±3.21、84.20±14.35,差异有统计学意义（t值分别为6.332、4.033、4.650、2.993、6.273,P均＜0.01�Objective To evaluate clinical application of VCS technology in diagnosis for acute leukemia and its subtypes by LH750 automated hematology analyzer. Methods A total of 178 leukemia patients （105 acute granilocytic leukemia, 42 acute lymphocytic leukemia, 31 acute monecytic leukemia）and 151 non-leukemia patients （86 granulocytic abnormal cases, 35 lymphocytic abnormal cases,30 monocytic abnormal cases） were enrolled into this study. Peripheral blood samples were analyzed by both Coulter LH750 automated hematology analyzer and manual microscopic examination. Microscopic examination was used as reference to evaluate the diagnosis value of VCS technology in blast detecting. VCS parameters were compared for AGL subsets. The clinical value of VCS technology in diagnosis for different acute leukemia was also evaluated by combining VCS scattergram and suspect flags provided by LH750. Results Compared with manual examination, a sensitivity of 95.5% （170/178） and specificity of 95.4% （144/151） were achieved by VCS technology in detecting blasts in acute leukemia and nonleukemia patients. In patients with AGL, the MNV, MNV-SD, MNC and MNC-SD （224.40 ± 23.37,37.40 ±12. 31,145. 80 ±7. 93,24. 79 ±5. 18） were higher than granulocytic abnormal patients（ 169.96 ±11.50,29.21 ± 5.27,133.30 ± 5.50, 10.62 ± 4.09） and the differences were statistically significant （ t values were 16. 832, 5. 148, 5. 735, 19. 953 respectively, P 〈 0. 01 ）. On the contrary, MNS （ 122. 90 ±6. 35） in AGL patients was significantly lower than granulocytic abnormal patients（ 131.00 ± 5. 69, t =-7.64, P〈0.01）. In patients with ALL, the MLV, MLV-SD, MLC, MLS, MLS-SD （97.60 ± 13.40,22. 35 ± 7.94,110. 00 ± 4. 60,77. 60 ± 19.00,20. 61 ± 3.30 ） were higher than lymphocytic abnormal patients（82. 10 ± 3.00, 14.41 ±2.35, 100.60 ±2.70, 48. 10 ±3.50, 17.60 ± 1.60）. The data also showed a statistical significance （t values were 7.576, 6. 118, 4. 041, 9. 353, 2. 988 respectively, P 〈0.05）. In pat

关 键 词：白血病 血细胞计数 诊断 

分 类 号：R733.7[医药卫生—肿瘤]