流式细胞分析在慢性粒-单核细胞白血病诊断中的价值探讨  

The Value of Flow Cytometry Analysis in the Diagnosis of Chronic Myelomonocytic Leukemia

作　　者：王淋 杜欣[1] WANG Lin;DU Xin(Department of Hematology,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,China)

机构地区：[1]血液内科,南方医科大学附属广东省人民医院(广东省医学科学院),广州510080

出　　处：《循证医学》2024年第3期173-177,共5页The Journal of Evidence-Based Medicine

基　　金：国家自然科学基金资助项目(82070176);广东省自然科学基金项目(2021A1515011436);广东省人民医院“登峰计划”科研专项(DFJHBF202107)。

摘　　要：慢性粒-单核细胞白血病(chronic myelomonocytic leukemia,CMML)是一种罕见的异质性血液系统恶性肿瘤,其重要特征之一是持续性单核细胞增多,这也是与其他疾病鉴别的关键,尤其需要与反应性单核细胞增多症进行鉴别。随着检验技术的不断进步以及对人类单核细胞亚群了解的增加,一些新的鉴别方法广泛应用,包括选取特定表面标志物、单核细胞亚群分型等方式。然而,通过流式细胞术选择特定表面标志物进行慢性粒-单核细胞白血病的诊断存在灵敏度低和特异性差的问题,而且至今尚未发现完全符合条件的表面标志物。对单核细胞亚群通过CD14/CD16分型定量,以单核细胞亚群占比进行慢性粒-单核细胞白血病的诊断与鉴别已经得到大量研究支持。但一些学者仍对这一方法在诊断中的准确性提出质疑,本文就该方面问题作一文献综述。Chronic myelomonocytic leukemia(CMML)is a rare heterogeneous hematological malignancy characterized by persistent monocytosis,which is crucial for distinguishing it from other diseases,especially reactive mononucleosis.With the development of testing technology and the increase in understanding of human monocyte subpopulations,some new identification methods are widely used,including selecting specific surface markers,typing monocyte subsets,and so on.However,the method of selecting specific surface markers by flow cytometry for the diagnosis of chronic myelomonocytic leukemia has problems of low sensitivity and poor specificity.Up to now,no completely qualified surface markers have been found.Some researchers proposed to quantify monocyte subsets by CD14/CD16 typing.The diagnosis of chronic myelomonocytic leukemia by the proportion of monocyte subsets has been supported by many studies.However,some scholars still question the accuracy of this method in diagnosis,and this article provides a literature review on this issue.

关 键 词：慢性粒-单核细胞白血病 流式细胞术 反应性单核细胞增多症 

分 类 号：R733.72[医药卫生—肿瘤]