外周血细胞形态学联合细胞化学染色诊断APL的临床价值分析  

Analysis of the clinical value of peripheral blood cell morphology combined with cytochemical staining in the diagnosis of APL

作　　者：谢祖林 吴波[2] 李可成 黎华连[1] 欧红娟[1] 张莹桃 XIE Zulin;WU Bo;LI Kecheng;LI Hualian;OU Hongjuan;ZHANG Yingtao(Laboratory Department,Liuzhou People's Hospital,Liuzhou 545006;Laboratory Department,Hospital of Chengdu University of TCM,Chengdu 610075,China)

机构地区：[1]柳州市人民医院检验科,广西柳州545006 [2]成都中医药大学附属医院检验科,四川成都610075

出　　处：《临床医学研究与实践》2023年第12期69-72,共4页Clinical Research and Practice

摘　　要：目的探讨外周血细胞形态学联合细胞化学染色诊断急性早幼粒细胞白血病(APL)的临床价值。方法收集2016年1月至2022年9月柳州市人民医院血液科诊治的63例APL患者的临床资料。回顾性分析63例APL患者的异常早幼粒细胞形态学特征及细胞化学染色结果特点。结果63例APL患者中,61例(96.8%)的异常早幼粒细胞核型呈“蝴蝶”状或“裤腿”状;63例(100.0%)均可见内外浆,外浆染蓝色,其中27例(42.9%)内浆充满粗颗粒,35例(55.6%)内浆充满混合颗粒,1例(1.6%)胞浆颗粒减少;48例(76.2%)见典型柴捆状Auer小体。63例APL患者涂片过氧化物酶(POX)染色呈强阳性;54例糖原染色(PAS)的异常早幼粒细胞胞浆均呈粉色弥漫细颗粒状阳性或/和边缘可见稍粗颗粒状阳性。结论充分认识异常早幼粒细胞形态学特征及其化学染色结果特点有助于早期快速诊断APL,利于临床及时诊治,降低死亡率,也提示临床应及早送检PML-RARα融合基因项目,及早明确诊断。Objective To explore the clinical value of peripheral blood cell morphology combined with cytochemical staining in the diagnosis of acute promyelocytic leukemia(APL).Methods The clinical data of 63 patients with APL diagnosed and treated in the hematology department of Liuzhou People's Hospital from January 2016 to September 2022 were collected.The morphological characteristics and cytochemical staining results of abnormal promyelocytes in 63 patients with APL were retrospectively analyzed.Results Among the 63 APL patients,61 cases(96.8%)had abnormal promyelocyte karyotypes with"butterfly"or"trouser-leg"shape;the inner and outer plasma in 63 cases(100.0%)were visible with blue staining of the outer plasmas,among them,27 cases(42.9%)were filled with coarse granules,35 cases(55.6%)were filled with mixed granules,and 1 case(1.6%)had decreased cytoplasmic granules;48 cases(76.2%)typical bundle-like Auer bodies were found.The smear of 63 patients with APL was strongly positive for peroxidase(POX)staining;the cytoplasm of abnormal promyelocytes stained by periodic acid-Schiff stain(PAS)in 54 cases showed pink diffuse fine granular positive or/and slightly coarse granular positive at the edge.Conclusion Fully understanding the morphological characteristics and chemical staining results of abnormal promyelocytes is helpful for early rapid diagnosis of APL,timely clinical diagnosis and treatment,and reducing mortality.It also suggests that PML-RARαfusion gene project should be sent for clinical examination as early as possible,and the diagnosis should be made as early as possible.

关 键 词：急性早幼粒细胞白血病 细胞形态学 细胞化学染色 早期诊断 

分 类 号：R733.7[医药卫生—肿瘤]