多参数流式细胞术检测人骨髓标本中非肿瘤性异常细胞表型研究  

Research of multiparameter flow cytometry in detecting non-neoplastic abnormal cell phenotypes in human bone marrow

作　　者：陈曼 王榕 周静 傅旻婧 赵玮 同格乐 王爱先 宫美维 王卉 Chen Man;Wang Rong;Zhou Jing;Fu Minjing;Zhao Wei;Tong Gele;Wang Aixian;Gong Meiwei;Wang Hui(Department of Laboratory Medicine,Hebei Yanda Lu Daopei Hospital,Langfang 065201,China;Department of Clinical Microbiology and Immunology,School of Medical Laboratory,Guizhou Medical University,Guiyang 550000,China;Department of Pathology and Medical Laboratory,Beijing Lu Daopei Hospital,Beijing 100176,China)

机构地区：[1]河北燕达陆道培医院检验科,廊坊065201 [2]贵州医科大学检验医学院临床微生物与免疫学教研室,贵阳550000 [3]北京陆道培医院病理与医学检验科,北京100176

出　　处：《中华检验医学杂志》2024年第7期740-746,共7页Chinese Journal of Laboratory Medicine

摘　　要：目的:分析多参数流式细胞术(MFC)检测骨髓标本中非肿瘤性异常表型相关疾病,包括意义不明的单克隆免疫球蛋白血症(MGUS)、单克隆B细胞增多症(MBL)、Fcγ受体Ⅲ类B(FcγRⅢB)缺失、CD36缺失等的表型特征。方法:回顾性观察性研究。选取2020年1月3日至2024年3月31日于河北燕达陆道培医院进行骨髓白血病/淋巴瘤一步法MFC筛查肿瘤性疾病的24 864例患者。收集患者一般临床资料以及MFC结果。根据年龄分为<45岁组(11 495例)、45~<60岁组(5 322例)、≥60岁组(7 081例);按疾病性质分为良性疾病组(8 336例)、恶性疾病组(15 562例)、其他组(966例)。分析各组骨髓标本中非肿瘤性异常表型的发生情况。结果:MGUS、MBL、FcγRⅢB缺失、CD36缺失的发生率分别为0.072%(18/24 864)、0.511%(127/24 864)、0.221%(55/24 864)、0.004%(1/24 864)。恶性疾病组MBL的发病率低于良性疾病组( P<0.001),MGUS的发病率高于良性疾病组( P=0.034)。良性疾病组中各疾病类型的MBL发生率比较,差异有统计学意义( P<0.001),其中全血细胞减少患者中MBL发生率最高为2.72%(48/1 765);恶性疾病组中,各疾病类型的MBL、MGUS发生率比较,差异均有统计学意义( P均<0.001),其中骨髓增生异常综合征/骨髓增殖性疾病患者发生率均最高,分别为1.95%(3/154)、1.30%(2/154)。 结论:应用MFC进行白血病/淋巴瘤一步法检测的非肿瘤性异常细胞表型特征存在一定差异,对疾病的筛查具有一定的借鉴意义。Objective To investigate the role of multiparameter flow cytometry(MFC)in detecting non-neoplastic abnormal phenotypes,including monoclonal gammopathy of undetermined significance(MGUS),monoclonal B-cell lymphocytosis(MBL),FcγreceptorⅢb(FcγRⅢB),and CD36 deficiencies.Methods A retrospective and observational study was conducted on a total of 24864 patients who underwent one-step screening for leukemia/lymphoma at Hebei Yanda Ludaopei Hospital from January 3,2020,to March 31,2024.Clinical data and MFC results of the patients were collected.Patients were grouped by age,group of<45 years(11495 cases),group of 45-<60 years(5322 cases),group of≥60 years(7081 cases)and disease nature,benign group(8336 cases),malignant group(15562),and other diseases group(966 cases).The incidence of non-neoplastic abnormal phenotypes was analyzed across groups.Results The incidence rates of MGUS,MBL,FcγRⅢB,and CD36 deficiencies were 0.072%(18/24864),0.511%(127/24864),0.221%(55/24864),and 0.004%(1/24864),respectively.MBL incidence was lower in the malignant group than in the benign group(P<0.001),while MGUS incidence was higher in the malignant group than in the benign group(P=0.034).The incidence rate of MBL among subtypes within the benign group varied significantly(P<0.001),with the highest incidence in patients with pancytopenia at 2.72%(48/1765).In the malignant group,the incidence of MBL differed significantly across various disease types(P<0.001),among which MDS/MPN exhibited the highest incidence at 1.95%(3/154)and 1.30%(2/154).Conclusion Utility of multiparameter flow cytometry method for one-step screening of leukemia and lymphoma shows variety in detecting non-neoplastic abnormal phenotypes,facilitating the identification of diseases.

关 键 词：流式细胞术 意义不明的单克隆免疫球蛋白血症 单克隆B细胞增多症 Fcγ受体Ⅲ类B缺失 

分 类 号：R446[医药卫生—诊断学] R733[医药卫生—临床医学]