评估骨髓、外周血红细胞和粒细胞CD55、CD59检测在PNH诊断中的应用  

To evaluate the application of marrow and peripheral blood erythrocyte and granulocyte CD55, CD59 detecting in the diagnosis of PNH

作　　者：李俊勋[1] 曾智杰[1] 陈海城[1] 欧阳涓[1] 

机构地区：[1]中山大学附属第一医院检验医学部,广州市510080

出　　处：《实用检验医师杂志》2012年第3期140-144,共5页Chinese Journal of Clinical Pathologist

摘　　要：目的评估骨髓红细胞、粒细胞CD55、CD59检测对阵发性睡眠性血红蛋白尿（paroxys—realnoturnal hemoglobinura，PNH）的诊断价值。方法收集107例PNH及其他-系至三系血细胞减少患者骨髓及外周血标本，采用流式细胞仪检测其红细胞、粒细胞CD55、CD59表达缺失情况。通过受试者工作特征（receiverOperatingcharacteristic，ROC）曲线评价各指标对PNH的诊断效能，并采用线性内插法计算其诊断PNH的诊断点。结果除PNH外，骨髓增生异常综合征、再生障碍性贫血、白血病及各类贫血患者的骨髓、外周血CD55-、CD59-红细胞、粒细胞比例，大多数均在5％以下。各疾病组间各指标比例差异均有统计学意义（P均〈0．05）。PNH患者各指标比例均较其他疾病患者高，且差异均有统计学意义（P均〈0．05）。造血干细胞疾病组与非造血干细胞疾病组的骨髓CD55-粒细胞比例差异无统计学意义（P〉0．05）。骨髓CD55-、CD59-红细胞、粒细胞比例诊断PNH的ROC曲线下面积均达0．700以上。各指标对PNH的诊断点分别为骨髓CD55红细胞4．81％，骨髓CD59-红细胞4．25％，骨髓CD55-粒细胞49．43％，骨髓CD59粒细胞4．63％，外周血CD55-红细胞3．99％，外周血CD59红细胞3．25％，外周血CD55-粒细胞4．17％，外周血CD59-粒细胞4．71％。结论骨髓红细胞、粒细胞CD55、CD59的诊断价值优于外周血，可以作为诊断PNH的辅助手段。Objective To study the diagnostic value of erythrocytes and granulocytes CD55, CD59 detecting in marrow for diagnosis of paroxysmal noturnal hemoglobinura （PNH）. Methods The marrow and peripheral blood sample of 107 PNH and cytopenia patients were enrolled. The CD55/CD59-defieient erythro- cytes and granuloeytes in marrow and blood samples were tested by flow cytometl：~. The performances of CD55/ CD59-deficient erythrocytes and granulocytes percentage to PNH were analyzed by receiver operating charac- teristic （ROC） curve. The diagnosis point of each index to PNH were calculated by linear interpolation. Results The ratio of CD55/CD59-deficient erythrocytes and granulocytes of marrow and peripheral blood in myelodys- plastic syndrome, aplastic anemia, leukemia and various kinds anemia were all lower than 5% except PNH. There were statistical significance in the differences of each index ratio among different disease groups （Pall〈 0.05 ）. The ratio of each index in PNH group were all higher than the other disease groups and the differences all had statistical significance （Pall〈 0.05）. There was no statistical significance in the difference of marrow CD55- granulocytes between hemopoietic stem cell disease group and non-hemopoietic stem cell disease group （P〉 0.05）. The area under ROC curve of the ratio of CD55/CD59-deficient erythroeytes and granulocytes of marrow were all higher than 0.700. The diagnosis point were marrow CD55 RBC （4.81%）, marrow CD59- RBC （4.25%）, marrow CD55- granuloeyte （49.43%）, marrow CD59- granulocyte （4.63%）, peripheral blood CD55- RBC（3.99%）, peripheral blood CD59 RBC（3.25%）, peripheral blood CD55- granulocyte （4.17%）, periph- eral blood CD59- granulocyte （4.71%）. Conclusion The diagnostic value of erythrocyte and granulocyte CD55, CD59 in marrow is better than that in peripheral blood,which can offer a useful information for diagno- sis of PNH.

关 键 词：阵发性睡眠性血红蛋白尿 CD55 CD59 流式细胞术 

分 类 号：R996[医药卫生—毒理学]