[1]崔 雪,崔建娇,丛玉珠,等.四种检验方法不同组合对急性髓系白血病和骨髓增生异常综合征的诊断价值研究[J].陕西医学杂志,2021,50(6):738-741.[doi:DOI:10.3969/j.issn.1000-7377.2021.06.025]
　CUI Xue,CUI Jianjiao,CONG Yuzhu,et al.Diagnostic value of different combinations of four test methods for AML and MDS[J].,2021,50(6):738-741.[doi:DOI:10.3969/j.issn.1000-7377.2021.06.025]
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四种检验方法不同组合对急性髓系白血病和骨髓增生异常综合征的诊断价值研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年6期
页码:
738-741
栏目:
临床检验
出版日期:
2021-06-05

文章信息/Info

Title:
Diagnostic value of different combinations of four test methods for AML and MDS
作者:
崔 雪1; 2; 崔建娇1; 丛玉珠3; 符 爽4; 张振忠4
(1.锦州医科大学附属第三医院,辽宁 锦州 121001; 2.抚顺市中心医院检验科,辽宁 抚顺 113006; 3.抚顺市中心医院微创外科,辽宁 抚顺 113006; 4.中国医科大学附属盛京医院血液研究室,辽宁 沈阳 110022)
Author(s):
CUI Xue; CUI Jianjiao; CONG Yuzhu; FU Shuang; ZHANG Zhenzhong
(The Third Affiliated Hospital of Jinzhou Medical University,Jinzhou 121001,China)
关键词:
急性髓系白血病;  骨髓增生异常综合征;  外周血涂片;  骨髓涂片;  流式细胞术;  染色体核型显带技术
Keywords:
Acute myeloid leukemia;  Myelodysplastic syndrome;  Peripheral blood smear;  Bone marrow smear;  Flow cytometry;  Chromosome karyotype banding technique
分类号:
R 557.1
DOI:
DOI:10.3969/j.issn.1000-7377.2021.06.025
文献标志码:
A
摘要:
目的:探讨外周血涂片、骨髓涂片、流式细胞术、染色体核型显带技术不同组合对急性髓系白血病(AML)和骨髓增生异常综合征(MDS)的诊断价值。方法:收集50例AML和50例MDS初诊患者,比较组合一(外周血涂片+骨髓涂片)、组合二(外周血涂片+骨髓涂片+流式细胞术)、组合三(外周血涂片+骨髓涂片+染色体核型显带技术)、组合四(外周血涂片+骨髓涂片+流式细胞术+染色体核型显带技术)的诊断检出率。结果:在50例AML患者中,组合一、二、三、四的诊断检出率分别为64%、90%、68%、92%。50例MDS患者中,组合一、二、三、四的诊断检出率分别为60%、84%、62%、86%。组合二、四诊断检出率高于组合一(均P<0.05)。组合三诊断检出率与组合一相比无统计学差异,组合二诊断检出率与组合四相比亦无统计学差异(均P>0.05)。结论:染色体异常可以为诊断提供相关遗传学证据,对化疗方案选择与预后评价提供参考,因此组合四对这两种疾病治疗方案的优化及预后评估更具有指导作用。而组合二可以大幅度提高AML与MDS的早期诊断水平,且检测费用相对不高,可以在基层医院推广。
Abstract:
Objective:To investigate the diagnostic value of different combinations of four test methods:peripheral blood smear,bone marrow smear,flow cytometry,and chromosome karyotype banding for acute myeloid leukemia(AML)and myelodysplastic syndrome(MDS).Methods:100 cases of newly diagnosed AML and MDS patients were collected.The diagnostic detection rate of first combination(peripheral blood smear+bone marrow smear),second combination(peripheral blood smear+bone marrow smear+flow cytometry),third combination(peripheral blood smear+bone marrow smear+chromosome karyotype banding technique),fourth combination(peripheral blood smear+bone marrow smear+flow cytometry+karyotype banding technique)were compared.Results:Among the 50 AML patients,the diagnostic detection rates of first combination,second combination,third combination and fourth combination were 64%,90%,68% and 92%,respectively.Among the 50 MDS patients,the diagnostic detection rates of first combination,second combination,third combination and fourth combination were 60%,84%,62% and 86%,respectively.The diagnosis detection rate of second combination and fourth combination was higher than that of first combination(all P<0.05).There was no statistical difference in the diagnosis detection rate between third combination and first combination,and the diagnosis detection rate of second combination was not different from fourth combination(all P>0.05).Conclusion:Chromosomal abnormalities can provide relevant genetic evidence for diagnosis,and provide references for the selection of chemotherapy regimens and prognostic evaluation.Therefore,the fourth combination has a guiding role in the optimization of treatment options and prognostic evaluation of these two diseases.The second combination can greatly improve the early diagnosis of AML and MDS,and the detection cost is relatively low,and it can be promoted in primary hospitals.

参考文献/References:

[1] 冯秀娟,石静云,吴 涛,等.急性髓系白血病基因突变研究进展[J].国际遗传学杂志,2020,43(1):52.
[2] 聂泽强,李晓云,马爻芳,等.WT1基因在骨髓增生异常综合征患者外周血中的表达及临床意义[J].陕西医学杂志,2019,48(8):977-980.
[3] 苏 静,张建富.外周血涂片、骨髓细胞形态特征在APL诊断中的价值[J].临床医药文献杂志,2018,5(44):152-155.
[4] 林 萍,谢若腾,张雅兰,等.细胞形态学在急性白血病中的诊断价值分析[J].中国实验血液学杂志,2019,27(6):1806.
[5] 肖志坚.骨髓增生异常综合征的精确诊断[J].中华血液学杂志,2015,36(5):361.
[6] 葛繁梅,刘延香,任 羽,等.急性髓系白血病128例免疫表型与预后的关系研究[J].陕西医学杂志,2014,43(4):454-456.
[7] Arber DA,Orazi A,Hasserjian R,et al.The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia[J].Blood,2016,127(20):2391-2405.
[8] 杨彩红,沈永明.血常规指标在儿童急性白血病诊断中的临床价值[J].继续医学教育,2019,33(7):130-132.
[9] 尹 钊,马保根,王怡斐,等.117例骨髓增生异常综合征患者ASXL1基因突变的临床研究[J].中华实用诊断与治疗杂志,2019,33(4):363-365.
[10] 朱建锋,郭 玮,潘柏申,等.含Auer小体样物质的非髓系肿瘤细胞临床与实验室特点分析[J].检验医学,2019,34(6):526-529.
[11] 伍 平,孙慧鹏,万凌君,等.γδ型肝脾T细胞淋巴瘤细胞形态学分析[J].中华医学杂志,2020,100(23):1805-1811.
[12] 中华医学会血液学分会.骨髓增生异常综合征中国诊断与治疗指南(2019年版)[J].中华血液学杂志,2019,40(2):89-97.
[13] 张琛晓,胡 婷,甘 明,等.病态造血在骨髓增生异常综合征诊断中的意义[J].当代医学,2019,25(22):146-147.
[14] 王伟伟,徐元宏.免疫表型及非髓系分化抗原表达分析[J].南方医科大学学报,2020,40(11):1639-1644.
[15] 郭 斌,谢 宁,刘 文,等.急性髓系白血病免疫分型及骨髓、血常规综合研究[J].国际检验医学杂志,2016,37(19):2710-2712.
[16] 赵咏梅,赵 蓉,李艳玲,等.MICM分型对未治型白血病的诊断价值[J].贵阳医学院学报,2016,41(2):231-233.
[17] 陈 芳,胡延平,王孝会.急性早幼粒细胞白血病免疫表型特点[J].中国实验血液学杂志,2016,24(2):321-325.
[18] 肖志坚.我国骨髓增生异常综合征的诊治现况及挑战[J].内科理论与实践,2020,15(5):281-284.
[19] 程小艳,武会娟.流式细胞术最新进展及临床应用[J].中国免疫学杂志,2019,35(10):1271-1276.
[20] 师锦宁,朱 雨,洪 鸣,等.急性髓细胞白血病基于遗传学突变的预后分析[J].中华医学遗传学杂志,2017,34(6):806-811.
[21] 张校辉,邢江涛,张玉娜,等.变异性急性早幼粒细胞白血病实验室检查结果分析[J].检验医学,2019,34(10):871-875.
[22] 肖志坚.骨髓增生异常综合征诊断的方法学:现况与问题[J].国际输血及血液学杂志,2019,42(2):93-97.
[23] 王 哲,徐梅珍,陈云飞,等.急性早幼粒细胞白血病治疗相关性髓系肿瘤四例报告并文献复习[J].中华血液学杂志,2019,40(12):1008-1014.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(81300420)
更新日期/Last Update: 2021-06-07