基于流式细胞术构建慢性粒细胞白血病的诊断模型  

A diagnostic model of chronic myelogenous leukemia based on flow cytometry

作　　者：马耀坤 商芳影 宋亮亮 马斌 刘钰 陈琼 刘万红[1] MA Yaokun;SHANG Fangying;SONG Liangliang;MA Bin;LIU Yu;CHEN Qiong;LIU Wanhong(Taikang Medical School(School of Basic Medical Sciences),Wuhan University,Wuhan 430071,China;Flow Cytometry Laboratory,Wuhan Kindstar Medical Laboratory Co.,Ltd.,Wuhan 430205,China)

机构地区：[1]武汉大学泰康医学院(基础医学院),湖北武汉430071 [2]武汉康圣达医学检验所有限公司流式细胞实验室,湖北武汉430205

出　　处：《生物资源》2024年第4期397-405,共9页Biotic Resources

基　　金：国家自然科学基金(52073022);武汉大学“基础-中南”共建项目培育基金(202205)。

摘　　要：流式细胞术的免疫分析在恶性血液病诊断中发挥着重要作用。然而在慢性粒细胞白血病慢性期(chronic myeloid leukemia in chronic phase,CML-CP)的诊断中,流式细胞术主要作为辅助诊断手段。本研究使用流式细胞术分析了500例CML-CP样本和106例非CML样本的免疫分析数据,采用统计学分析方法对CML组和非CML组进行显著性检验,并通过logistic回归构建诊断模型。结果显示,CML组和非CML组在Neu%、Baso%、CD10+%、CD38+%、CD56+%、CD64+CD16-%、CD15+CD11b+%和Eos%等标志物上存在显著差异(p <0.01);并利用步进法构建出CMLflowscore诊断公式,该公式除常数外由5个指标构成,其受试者操作特征(receiver operating characteristic,ROC)曲线下面积为0.989,灵敏度为98.0%,特异性为96.2%。值得注意的是,本研究发现了CML-CP在流式细胞诊断过程中的潜在诊断标志物,并构建了新的诊断公式,这些发现可以让流式细胞术在CML-CP的初次诊断中发挥关键作用。Flow cytometry immunophenotyping plays a prominent role in diagnosis of malignant hematological disor⁃ders.However,in the diagnosis of chronic myeloid leukemia in chronic phase(CML⁃CP),flow cytometry serves primar⁃ily as an auxiliary diagnostic tool.We analyze the immunoassay data from 500 CML⁃CP patients and 106 non⁃CML pa⁃tients with flow cytometry,use statistical analysis to test the significance of CML and non⁃CML groups,and construct di⁃agnostic model by logistic regression.The results show that there are significant differences(p<0.01)between the markers of CML and non⁃CML groups,such as Neu%,Baso%,CD10+%,CD38+%,CD56+%,CD64+CD16-%,CD15+CD11b+%,and Eos%.The stepwise method is used to construct the CMLflowscore diagnostic formula,which consisted of five indicators in addition to the constant,and its area under the receiver operating characteristic(ROC)curve is 0.989,with a sensitivity of 98.0%and a specificity of 96.2%.Notably,the potential diagnostic markers for CML⁃CP are identified,and a novel diagnostic formula is constructed.These findings suggest that flow cytometry can play a crucial role in the initial diagnosis of CML⁃CP.

关 键 词：慢性粒细胞白血病 流式细胞术 诊断 CMLflowscore 

分 类 号：R733[医药卫生—肿瘤]