细胞遗传学联合流式细胞术在骨髓增生异常综合征诊断效果和危险分层及预后中的价值研究  

The value of cytogenetics combined with flow cytometry in the diagnosis effec,risk stratification and prognosis of myelodysplastic syndromes

作　　者：陈贱兰 谢陆华 谢玉萍 辛小琴 卢沛林 CHEN Jianan;XIE Luhua;XIE Yuping;XIN Xiaoqin;LU Peiin(Department of Laboratory Medicine,Ganzhou People's Hospital,Ganzhou,Jiangxi,341000,China;Laboratory Department,Maternal and Child Health Hospital,Yudu County,Ganzhou,Jiangxi,342300,China)

机构地区：[1]赣州市人民医院检验科,江西赣州341000 [2]于都县妇幼保健院检验科,江西赣州342300

出　　处：《当代医学》2024年第3期83-86,共4页Contemporary Medicine

基　　金：赣州市指导性科技计划项目(GZ2020ZSF173)。

摘　　要：目的探讨细胞遗传学联合流式细胞术在骨髓增生遗传综合征(MDS)患儿中的诊断效果、危险分层及预后的价值。方法选取2019年5月至2021年5月赣州市人民医院检验科收治的97例疑似MDS患者作为研究对象,常规给予细胞遗传学和流式细胞术检查,并以临床最终检查结果为金标准,分析细胞遗传学、流式细胞术在骨髓增生遗传综合征中的诊断效能;对患儿随访12个月,根据流式细胞术积分系统对患者进行危险分层评估,分析不同危险分层下患者的预后并进行相关性分析。结果细胞遗传学联合流式细胞术检查确诊65例,检查准确度为88.66%、灵敏度为89.71%、特异度为86.21%;细胞遗传学联合流式细胞术检查在MDS中检查准确度高于单一检查方法(P<0.05);灵敏度、特异度、阳性预测值和阴性预测值略高于单一细胞遗传学、流式细胞术检查,但其诊断效能差异无统计学意义。低危患者总体生存时间长于中危和高危患者,且中危患者总体生存时间长于高危患者,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,MDS患者分层与患者总生存时间呈负相关(r<0,P<0.05)。结论细胞遗传学与流式细胞术用于MDS患者中均具有较高的检出率,且二者联合检测能提高诊断效能,利用流式细胞术积分系统能完成患者危险分层,与患者预后存在强相关性。Objective To explore the diagnostic effect,risk stratification,and prognostic value of cytogenetics combined with flow cytometry in children with myelodysplastic syndromes(MDS).Methods 97 suspected MDS patients from May 2019 to May 2021 were selected as the study sub-jects,and routine cytogenetic and flow cytometry examinations were performed.The clinical final examination results were used as the"gold stan-dard"to analyze the diagnostic efficacy of cytogenetics and flow cytometry in MDS;follow up the patient for 12 months,evaluate the risk stratifica-tion of the patient based on the flow cytometry scoring system,the prognosis of patients under different risk stratification were analyzed,and conduct correlation analysis.Results 65 cases were confirmed by the cytogenetics combined with flow cytometry,accuracy was 88.66%,sensitivity was 89.71%,and specificity was 86.21%;the accuracy of cytogenetics combined with flow cytometry examination in MDS was higher than that of single examination method(P<0.05);the sensitivity,specificity,positive predictive value,and negative predictive value were slightly higher than those of single cell genetics and flow cytometry tests,but the difference in diagnostic efficacy was not statistically significant.The overall survival time of low-risk patients was longer than that of medium and high-risk patients,and the overall survival time of medium risk patients was longer than that of high-risk patients,the differences were statistically significant(P<0.05).The Pearson correlation analysis results showed a negative correlation between the stratification of MDS patients and the total survival time of patients(r<0,P<0.05).Conclusion Both cytogenetics and flow cytometry have high detection rate in MDS patients,and their combined detection can improve diagnostic efficiency,the use of flow cytometry scoring system can complete patient risk stratification,and there is a strong correlation with patient prognosis.

关 键 词：细胞遗传学 流式细胞术 骨髓增生异常综合征 诊断效果 危险分层 预后 

分 类 号：R551.3[医药卫生—血液循环系统疾病]