应用流式细胞术评分诊断骨髓增生异常综合征  

Application of flow cytometric score in the diagnosis of myelodysplastic syndromes

作　　者：王洪岩[1] 程梅[1] 杨秀丽[1] 陈立君[1] 马军[1] 

机构地区：[1]黑龙江省哈尔滨市第一医院血液肿瘤研究所检验科,150010

出　　处：《白血病．淋巴瘤》2014年第9期530-533,537,共5页Journal of Leukemia & Lymphoma

摘　　要：目的 采用流式细胞术（FCM）评分对骨髓增生异常综合征（MDS）与非MDS（主要为非克隆性血细胞减少患者）患者进行鉴别.方法 应用FCM四参数（CD34＋髓系原始细胞占所有有核细胞百分比、B系祖细胞占CD34＋细胞百分比、髓系原始细胞CD45表达水平、成熟粒细胞SSC峰通道值）对50例MDS患者和20例非MDS患者进行评分,每个参数异常时计1分,评分≥2分时诊断为MDS.结果与非MDS对照组比较,MDS患者CD34＋髓系原始细胞比例增高,B系祖细胞比例降低,成熟粒细胞SSC水平降低,差异有统计学意义（P＜0.05）;而CD34＋髓系原始细胞CD45表达水平差异无统计学意义（P=0.06）.MDS组FCM评分高于非MDS组,差异有统计学意义（P＜ 0.001）.45例患者用此方法正确诊断为MDS,敏感度为90％;1例患者为假阳性,特异度为95％.结论 采用FCM四参数评分可帮助诊断MDS,可行性好,简单方便.Objective To identify myelodysplastic syndromes （MDS） from non-MDS （mainly non-clonal cytopenias） by flow cytometric （FCM） score.Methods Four parameters （CD34＋ myeloblast-related and B-progenitor-related cluster size,myeloblast CD45 expression and granulocyte side scatter value） were rated on 50 patients with MDS and 20 patients with non-clonal cytopenias.A diagnosis of MDS was formulated in the presence of FCM score value ≥ 2 （every abnormal parameter was scored 1）.Results When compared with non-clonal cytopenias,patients with MDS had increased myeloblast-related cluster size and decreased B-progenitor-related cluster size,and had a lower granulocyte side scatter （P ＜ 0.05）,but no significant difference was found when myeloblast CD45 expression was compared （P =0.06）.The FCM score value was significant higher in MDS patients （P ＜ 0.001）.45 cases were correctly classified （sensitivity 90 ％）.There was 1 false-positive case among 20 controls （specificity 95 ％）.Conclusion The FCM score may help to establish the diagnosis of MDS,and it is simple and feasible.

关 键 词：骨髓增生异常综合征 流式细胞术 敏感性 特异性 

分 类 号：R551.3[医药卫生—血液循环系统疾病]