摘要
目的分析血常规、骨髓细胞涂片、活检、骨髓流式免疫分型(FCM)及分子遗传学检查对初诊骨髓增生异常综合征诊断的应用价值。方法回顾性分析芜湖市第二人民医院2014年8月-2020年11月收治的75例初诊骨髓增生异常综合征患者的血常规,比较骨髓涂片、活检及FCM对粒、红、巨各系病态造血及原始细胞的检出率,分析分子遗传异常与病态造血的关系,评估各项检查在初诊骨髓增生异常综合征诊断中的应用价值。结果75例初诊骨髓增生异常综合征患者中,骨髓涂片对红系、粒系病态造血检出率高于活检(红系:76.0%vs.45.3%,粒系:48.0%vs.24.0%),差异有统计学意义(P=0.002、0.010),而对巨核系病态造血的检出率低于活检(32.0%vs.40.0%),差异有统计学意义(P=0.048);且对骨髓增生程度及纤维组织增生判断,活检有明显优势。FCM对粒系发育异常(52.7%)及原始细胞检出率(36.3%)高于活检和涂片。分子遗传异常组的初诊骨髓增生异常综合征患者中细胞发生病态造血的概率(90.0%)高于正常组(82.4%)。涂片、活检及FCM联合检测对红系、粒系、巨核系病态造血检出率(80.0%、58.6%、50.7%)和原始细胞检出率(40.0%)均高于涂片、活检及FCM单一检查手段。结论骨髓涂片、活检、FCM及分子遗传学检查在初诊骨髓增生异常综合征诊断中各有优势,联合项检测可提高诊断阳性率。
Objective To explore the diagnosis value in the disease of newly diagnosed myelodysplastic syndrome(MDS)by means of blood routine,bone marrow smear,biopsy,flow cytometry(FCM)and molecular genetic examination.Methods A total of 75 patients with MDS were selected in the Second People’s Hospital of Wuhu City from August 2014 to November 2020 for retrospective analysis and detected by using blood routine test,bone marrow smear,biopsy and FCM to look for morbid hematopoiesis of granulocyte,erythropoiesis and megakaryocyte and primitive cells,respectively.The correlation between abnormal molecular genetics and morbid hematopoiesis were analyzed to evaluate the value of different method for MDS diagnosis.Results Among the 75 MDS patients,the detection rate of morbid hematopoiesis of erythroid cells and granulopoiesis using bone marrow smear was higher than biopsy(erythroid cells:76.0%vs.45.3%,P=0.002;granulopoiesis:48.0%vs 24.0%,P=0.010);however,the rate of megakaryocyte was lower(32.0%vs.40.0%,P=0.048).And to judge the hyperplasia degree of bone marrow and fibrous tissue biopsy was superior than that of blood smear.By FCM,the detection rates of granulocytic morbid hematopoiesis(52.7%)and primitive cells(36.3%)were higher than both biopsies and smears.The incidence of morbid hematopoiesis in MDS patients with abnormal molecular genetics(90.0%)was higher than that in the normal group(82.4%).The detection rates of morbid hematopoiesis of erythropoiesis,granulocyte and megakaryocyte(80.0%,58.6%,50.7%)and primitive cells(40.0%)by combined examination of smear,biopsy and FCM were higher than that by single examination of smear,biopsy and FCM.Conclusion Bone marrow smear,biopsy,FCM and molecular genetic examination showed their own advantages and disadvantages in the MDS diagnosis respectively and multiple laboratory tests could improve the positive rate.
作者
翟小燕
赵敏
唐晓磊
ZHAI Xiao⁃yan;ZHAO Min;TANG Xiao⁃lei(Department of Laboratory,the Second People's Hospital of Wuhu City,Wuhu,Anhui 241000,China;Department of Hematology,the Second People's Hospital of Wuhu City,Wuhu,Anhui 241000,China;Vascular Disease Research Center&Basic Medical Laboratory,the Second Affiliated Hospital of Wannan Medical College,Wuhu,Anhui 241000,China)
出处
《热带医学杂志》
CAS
2022年第12期1652-1655,共4页
Journal of Tropical Medicine
基金
国家自然科学基金(81601806)
作者简介
翟小燕(1982-),女,本科,主管检验师,研究方向:骨髓细胞学诊断;通信作者:唐晓磊,E⁃mail:278471655@qq.com
