Hematoflow技术用于白血病筛查及化疗疗效监测临床价值  

Clinical Application of Hematoflow Method to Screening Leukemia and Monitoring Efficacy of Chemotherapy

作　　者：何一波[1] 刘永林[2] 李晓芳[2] 施丽华[2] 彭来君[2] 杨正东[1] 陈益民[2] HE Yibo LIU Yonglin LI Xiaofang SHI Lihua PENG Laijun YANG Zhengdong CHEN Yinmin(The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou（310002）, China Clinical Labo- ratory, the First Hosptial Affiliated to Zhejiang Chinese Medical University, Hangzhou（310006)

机构地区：[1]浙江中医药大学第一临床医学院,杭州310002 [2]浙江中医药大学附属第一医院检验科,杭州310006

出　　处：《浙江中西医结合杂志》2017年第5期381-384,共4页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家中医药管理局科研基金(No.JDZX2015111)

摘　　要：目的探讨Hematoflow技术在筛查早期白血病及监测化疗疗效的临床应用价值。方法收集血液科门诊及住院患者342例共计455份EDTA-K2抗凝的外周血样本,应用血细胞分析仪、形态学镜检、Hematoflow分类计数外周血白细胞,计算其相关性;以形态学镜检法为金标准,评价Hematoflow分类计数原始细胞的特异性和灵敏度;形态学镜检计数14例初发白血病化疗前后的骨髓原始细胞,观察与Hematoflow计数外周血原始细胞的相关性。结果与形态学镜检法相比,Hematoflow、血细胞分析仪分类计数中性粒细胞、嗜酸性粒细胞、淋巴细胞、单核细胞呈现明显正相关(r=0.821、0.863、0.845、0.690,0.703、0.882、0.802、0.475,P<0.05);以形态学镜检法为金标准,原始细胞≥1%为临界值,Hematoflow法检出原始细胞的灵敏度为100%,特异性为97.3%,准确度为97.8%;急性白血病患者化疗前后骨髓原始细胞的变化值与Hematoflow计数外周血原始细胞的变化值呈正相关(r=0.704,P<0.01)。结论 Hematoflow分类计数外周血白细胞准确、可靠,检测原始细胞方法学快速、特异、灵敏、自动化,尤其对低白细胞总数的样本,在白血病筛查及疗效监测中具有较高的临床应用价值。Objective To investigate the clinical application of Hematoflow method to screening leukemia and monitoring the effect of chemotherapy. Methods A total of 455 peripheral blood samples through EDTA-K2 anti- coagulation from 342 inpatients and outpatients in Department of Hematology were collected in this study. Leuko- eytes in these samples were counted with automated hematology analyzer, morphology observation and Hematoflow method, separately, then the correlation among these results was calculated. The specificity and sensibility of Hematoflow method were analyzed and compared to morphology observation as a reference method. Blast cells from 14 patientswith primary leukemia before and after chemotherapy were collected to make a comparison with Hematoflow method. Results The correlation between Hematoflow method, hematology analyzer and morphological observation was good for neutrophils, lymphocytes, monocytes, basophils and eosinophils （r=0.821, 0.863, 0.845, 0.690, 0.703, 0.882, 0.802, 0.473, P〈0.05）. When the cutoff value of blast count by Hematoflow method was set at 1%, the sensitivity was 100%, the specificity was 97.3%, and the accuracy was 97.8%, referred to morphological observation （P〈0.05）. The correlation between Hematoflow method and bone marrow examination for blasts variation was good in 14 patients undergoing chemotherapy （r=0.704, P〈0.01）. Conclusion Hematoflow method is accurate and available for leukocyte differential count and has high sensitivity and specificity for blasts differential count, especiallyhaving excellent diagnostic efficiency in the sample of leukopenia.

关 键 词：白血病 白细胞分类计数 Hematoflow技术 流式细胞术 血细胞形态学 

分 类 号：R733.7[医药卫生—肿瘤]