CD200在慢性淋巴细胞白血病相关疾病诊断中的价值  

The clinical value of CD200 in the diagnosis of chronic lymphocytic leukemia-related diseases

作　　者：洪俊[1] 饶永彩[2] HONG Jun;RAO Yongcai(Department of Clinical Laboratory,Renmin Hospital of Wuhan University,Wuhan,Hubei 430060,China;Wuhan Institute of Biological Products,Wuhan,Hubei 430060,China)

机构地区：[1]武汉大学人民医院检验科,湖北武汉430060 [2]武汉生物制品所,湖北武汉430060

出　　处：《国际检验医学杂志》2022年第13期1653-1657,共5页International Journal of Laboratory Medicine

摘　　要：目的评估CD200在慢性淋巴细胞性白血病(CLL)诊断中的临床价值,探讨在Matutes免疫表型评分(MS)系统中添加CD200是否可以提高原有免疫表型评分系统在CLL诊断中的效能。方法采用流式细胞术对136例CLL相关疾病患者(CLL相关组)和64例非CLL相关疾病患者(非CLL相关组)骨髓标本中的CD5、CD23、FMC7、SmIg、CD79b和CD200等多种标志物表达情况进行检测。CD200表达水平的表示方式有阳性细胞百分比和平均荧光强度比(MFIR)两种。分析CD200作为单个标志物用于诊断CLL相关疾病的灵敏度、特异度和准确性。采用McNemar检验评估改进后的免疫表型评分系统(包含CD200)和原MS在CLL相关疾病临床诊断中诊断效能的差异。结果CD200在CLL相关组的表达水平,无论是以阳性细胞百分比还是以MFIR表示,均高于非CLL相关组(P<0.05)。CD200作为CLL诊断的单个标志物,表达水平以阳性细胞百分比表示时,其灵敏度明显高于FMC7、CD79b和SmIg(P<0.05),与CD23和CD5相比差异均无统计学意义(P>0.05);其特异度明显低于其他标志物(P<0.05);而其准确性明显高于SmIg(P<0.05),而与其他MS标志物相似(P>0.05)。在MS中添加CD200后改变了200例研究对象中19例的临床诊断,可正确识别136例CLL相关疾病患者中的124例,将MS的CLL诊断准确性从84.3%提高到94.7%(McNemar检验,P<0.01)。结论CD200是CLL诊断中有价值的标志物,单个标志在CLL诊断中特异性不强,但当结合MS时可显著提高CLL诊断的准确性。Objective To evaluate the clinical value of CD200 in the diagnosis of chronic lymphocytic leukemia(CLL),and to explore whether adding CD200 to the Matutes immune phenotype scoring(MS)system can improve the diagnostic efficacy of the original immune phenotype scoring system in the diagnosis of CLL related diseases.Methods CD5,CD23,FMC7,SmIg,CD79b,CD200 in bone marrow specimens of 136 patients with CLL-related diseases(CLL-related group)and 64 patients with non-CLL-related diseases(non-CLL-related group)were analyzed by flow cytometry.The expression levels of CD200 were measured by the percentage of positive cells and MFIR.The sensitivity,specificity and accuracy of CD200 as a single marker for diagnosing CLL-related diseases were analyzed.The McNemar′s test was used to evaluate the difference in diagnostic performance between the improved immunophenotype scoring system(including CD200)and the original MS in the clinical diagnosis of CLL-related diseases.Results The expression level of CD200 in the CLL-related group,whether measured in the percentage of positive cells or MFIR,was higher than that in the non-CLL-related group(P<0.05).As a single marker for the diagnosis of CLL,when the expression level is measured in the percentage of positive cells,its sensitivity is significantly higher than that of FMC7,CD79b and SmIg(P<0.05),and there is no significant difference compared with CD23 and CD5(P>0.05);its specificity was significantly lower than other markers(P<0.05);its accuracy was significantly higher than SmIg(P<0.05),and similar to other MS markers(P>0.05).The addition of CD200 to MS changed the clinical diagnosis of 19 of 200 patients,correctly identified 124 of 136 patients with CLL-related disease,and improved the accuracy of CLL diagnosis in MS from 84.3%to 94.7%(McNemar′s test,P<0.01).Conclusion CD200 is a valuable marker in the diagnosis of CLL,when used as a single marker it is not very specific in the diagnosis of CLL,but it can significantly improve the accuracy of CLL diagnosis when combined with

关 键 词：慢性淋巴细胞性白血病相关疾病 CD200 免疫表型 流式细胞术 

分 类 号：R446.61[医药卫生—诊断学]