计算机网格计点法定量分析骨髓纤维增生在成人急性淋巴细胞白血病中的应用  

Computer based graticule to quantify bone marrow reticulin fiber density in adult acute lymphoblastic leukemia

作　　者：翟元梅[1] 俞夜花[1] 吴振添[1] 万云[1] 章菁[2] 王慧[1] 刘四红[2] 石军[1] 

机构地区：[1]上海交通大学附属第六人民医院血液科,上海200233 [2]苏州大学医学部

出　　处：《临床血液学杂志》2014年第4期586-588,共3页Journal of Clinical Hematology

基　　金：国家自然基金面上项目(No:81170507);上海市科委课题(No:11140903700)

摘　　要：目的:通过新型计算机网格计点法定量分析骨髓纤维化强度,并探讨其与成人急性淋巴细胞白血病(ALL)患者预后的相关性。方法:以抽吸-活检一步取材法采集33例初发成人ALL患者及31例正常者骨髓,塑料包埋后切片行Gomori染色,光学显微镜成像系统摄片;依据网型测微器原理建立计算机网格记点软件,比较其与传统骨髓纤维化人工半定量评价等级的异同,进一步对所有骨髓网硬蛋白强度(RFD)进行定量分析,研究其与ALL预后的相关性。结果:我们建立的新型计算机网格计点法对骨髓RFD的定量与人工半定量纤维化等级法具有相同趋势(r2=0.792,P<0.05),但更精确;初发ALL患者骨髓RFD较正常者明显增高[(5.78±0.56)%∶(1.26±0.09)%,P<0.05];Cox回归模型分析ALL患者初发骨髓RFD为其预后不良因素,当RFD>3.64%时相对危险度最高,且该组患者总生存期明显少于RFD≤3.64%患者(P<0.05)。结论:新型计算机网格计点法能够准确定量骨髓RFD;ALL初发患者异常增殖的纤维组织是其预后不良的潜在高危因素。Objective：To introduce a computer based 121-point graticule to quantify bone marrow reticulin fiber density（RFD）in adult primary acute lymphoblastic leukemia（ALL）,and to investigate the co-relation between RFD and prognosis of patients.Method：Bone marrow（BM）was collected by aspiration/trephine biopsy from 33adult ALL patients at diagnosis and 31healthy volunteers.BM sections were stained by Gomori,and then viewed by optical microscope imaging system.Computer based 121-point graticule and artificial semi-quantitative of fibrosis grade evaluation were used to assess RFD,and the co-relation of the two methods was investigated.Subsequently,computer based 121-point graticule was used to investigate the relationship between RFD and leukemia prognosis.Result：Artificial semi-quantitative of fibrosis grade evaluation and computer based 121-point graticule carried a significant positive correlation in RFD assessment for primary ALL（r2=0.792,P〈0.05）.RFD in primary ALL was significantly increased than that in healthy volunteers[（5.78±0.56）% vs（1.26±0.09）%,P〈0.05].Cox regression analysis showed RFD was a poor prognostic factor.The cut-off used for RFD was decided by exploring RFD data in Cox＇s analyses dividing the material by the highest RR with RFD value〉3.64%.Kaplan-Meier survival analysis displayed overall survival in patients with RFD〉3.64% was significantly less than that in patients with RFD≤3.64%（P〈0.05）.Conclusion：Computer image system might precisely quantify RFD in primary ALL and it is a high risk factor in prognosis heralding.

关 键 词：白血病 淋巴细胞 急性 骨髓纤维组织增生 计算机 

分 类 号：R733.71[医药卫生—肿瘤]