脑脊液流式细胞术在检测中枢神经系统白血病中的应用  

Value of Cerebrospinal Fluid Detection with Flow Cytometry in the Diagnosis of Central Nervous System Leukemia

作　　者：孙雪静[1] 万岁桂[1] 刘聪燕[1] 贺景娟[1] 刘艳[1] 张维[1] 赵弘[1] 徐娟[1] 

机构地区：[1]首都医科大学宣武医院血液科,北京100053

出　　处：《现代检验医学杂志》2014年第6期78-80,共3页Journal of Modern Laboratory Medicine

摘　　要：目的：探讨流式细胞术（flow cytometry，FCM）对患者脑脊液（cerebrospinal fluid，CSF）细胞免疫表型的检测，在诊断中枢神经系统白血病（central nervous system leukemia，CNS-L）中的价值。方法采用多色流式细胞术 CD45／SSC双参数散点图设门方法，对195例患者CSF细胞免疫表型进行分析，同时行细胞形态学检测，比较两种方法的差异。结果195例患者中有71例为非霍奇金淋巴瘤（Non-Hodgkin’s lymphoma，NHL）患者，FCM检测有24例发现异常表型细胞，阳性率为33.80％。经形态学分析，15例发现异常细胞，其阳性率为19.72％，差异具有统计学意义（P＝0.022）。58例急性淋巴细胞白血病（acute lymphoma leukemia，ALL）患者，FCM检测有13例发现异常表型细胞，阳性率为22.41％。经形态学分析，12例发现异常细胞，其阳性率为18.97％，差异无统计学意义（P＝1.000）。66例急性非淋巴细胞白血病（acute nonlymphocytic leukemia，ANLL）患者，经 FCM和形态学检测均有4例患者检测出异常细胞，其阳性率均为5.97％，差异无统计学意义（P＝1.000）。结论脑脊液 FCM检测敏感性高，淋巴瘤患者行 FCM分析更有助于中枢神经白血病的诊断，是细胞形态学检测方法的重要补充。Objective To explore the clinical diagnostic significance of cerebrospinal fluid （CSF）detection with flow cytome-try （FCM）in central nervous system leukemia （CNS-L）.Methods The 1 9 5 cerebrospinal fluid （CSF）samples were ana-lyzed using four-color flow cytometry by CD45/SSC secondary gating strategy and detected by conventional cell morpholo-gy.Results The results showed that 24 （33.80%）patients had abnormal cells by flow cytometry and 15 （19.72%）pa-tients had abnormal cells by conventional cell morphology in 71 Non-Hodgkin’s lymphoma （NHL）patients,respectively. The difference was statistically significant （P=0.022）.The results showed that 13 （22.41%）patients had abnormal cells by flow cytometry and 1 2 （1 8.9 7%）patients had abnormal cells by conventional cell morphology in acute lymphoma leuke-mia （ALL）patients,respectively.The difference was no statistically significant （P=1.000）.The results showed that 4 （5.9 7%）patients had abnormal cells by flow cytometry and 4 （5.9 7%）patients had abnormal cells by conventional cell morphology in acute nonlymphocytic leukemia （ANLL）patients,respectively.The difference was no statistically significant （P=1.000）.Conclusion Cerebrospinal fluid （CSF）detection with flow cytometry （FCM）may be helpful in the diagnosis of central nervous system leukemia in NHL.It has higher sensitivity and is an important supplement to CSF conventional cell morphology.

关 键 词：流式细胞术 脑脊液 免疫分型 中枢神经系统白血病 

分 类 号：R446.14[医药卫生—诊断学]