急性白血病细胞髓过氧化物酶染色与细胞质髓过氧化物酶诊断意义比较  

Comparison of diagnostic significance between myeloperoxidase staining and cytoplasm myeloperoxidase in acute leukemia cells

作　　者：陈姣[1] 金咏梅[1] 郑沁[1] 史青[1] 陈杏园 粟军[1] 

机构地区：[1]四川大学华西医院实验医学科,成都610041

出　　处：《华西医学》2017年第7期1019-1023,共5页West China Medical Journal

基　　金：国家自然科学基金(81201343)

摘　　要：目的通过对急性白血病细胞细胞化学染色法检测过氧化物酶(peroxidase,POX)与流式细胞术检测其细胞质髓过氧化物酶(cytoplasm myeloperoxidase,c MPO)的结果分析,对比两种方法检测髓过氧化物酶(myeloperoxidase,MPO)对白血病分型的差异,为更准确地进行白血病分型提供依据。方法用细胞化学染色法检测急性白血病细胞POX阳性率,用流式细胞术检测急性白血病细胞c MPO阳性率,并对POX、c MPO阳性率及阳性细胞积分结果进行比较。结果急性淋巴细胞白血病中细胞化学染色检测POX与流式细胞术检测c MPO阳性率和阳性积分差异均有统计学意义(P<0.05),POX明显较高;急性非淋巴细胞白血病细胞POX、c MPO阳性率差异有统计学意义(P<0.05),c MPO阳性率较高;但POX、c MPO阳性细胞积分差异无统计学意义(P>0.05)。急性髓系白血病,未分化型(M1)的POX、c MPO阳性率差异有统计学意义(P=0.006),c MPO阳性率明显高于POX阳性率,但POX阳性细胞积分明显高于流式细胞术c MPO阳性积分(P=0.001);急性髓系白血病,伴成熟型(M2)、急性早幼粒细胞白血病(M3)、急性粒-单核细胞白血病(M4)、急性单核细胞白血病(M5)的POX、c MPO阳性率及阳性细胞积分差异均无统计学意义(P>0.05)。结论细胞化学染色检测POX与流式细胞术检测c MPO的阳性率及阳性细胞积分在急性白血病尤其急性髓系白血病中差异不大,二者各有优缺点,可以根据实际情况和对敏感性的要求选择适合的试验方法,最优方案是两种方法相互补充,以形态学作为基础,细胞免疫学作为辅助,同时进一步结合临床表现、遗传学检查等因素综合分析,进行血液系统疾病的诊断。Objective To detect the difference between the peroxidase （POX） by cytochemical staining and cytoplasm myeloperoxidase （cMPO） by flow cytometry in acute leukemia cells, and provide a more accurate basis for the classification of leukemia. Methods The positive rate of POX in acute leukemia cells was detected by cytochemical staining. The positive rate of cMPO in acute leukemia cells was detected by flow cytometry. Then the positive rate of POX and cMPO, and the positive cells score were analyzed. Results The positive rate and the positive cells scores between POX and cMPO in acute lymphoblastic leukemia were significantly different （P〈0.05）, the positive rate and the positive cells scores of POX were significantly higher than those of cMPO. The positive rate between POX and cMPO in acute non- lymphoblastic leukemia （ANLL） had significant differences （P〈0.05）, the positive rate of cMPO was higher than that of POX; but no difference was found between POX and cMPO positive cells scores in ANLL （P〉0.05）. In acute myelocytic leukemia （AML）-M1 subtype, significant difference was found in the positive rate between POX and cMPO （P=0.006）; cMPO positive rate was significantly higher than that of POX, but the POX positive cells score was significantly higher than that of cMPO （P=0.001）. There were no significances of positive rate and positive cells score in AML-M2, AML-M3, AML-M4, AML-M5 subtypes between POX and cMPO （P〉0.05）. Conclusions There are not major differences between positive rate of POX and cMPO, as well as the positive cells scores in acute leukemia, especially acute myelocytic leukemia. We can choose the better method according to the actual situation and the sensitivity requirements. The two methods should be replenished by each other and used alternately.

关 键 词：急性白血病 过氧化物酶染色 细胞质髓过氧化物酶流式细胞术 

分 类 号：R733.71[医药卫生—肿瘤]