81例急性单核细胞白血病电镜诊断分析

The study of electron microscopy diagnosis of 81 cases with acute monocytic leukemia

目的分析81例临床根据FAB标准诊断为急性单核细胞白血病(M5)的电镜诊断结果和电镜MPO组化分布特点.方法电镜观察81例临床诊断为M5的骨髓有核细胞超微结构并计数MPO阳性细胞,总结电镜和FAB诊断相符情况以及MPO阳性细胞率.结果电镜与临床诊断符合病例59例(72.8%),诊断不一致16例(19.7%),未提示诊断病例6例(7.4%);电镜下所有M5MPO阳性细胞率范围在0～100%之间,MPO阳性细胞率和M5例数所占百分比之间呈两极分化趋势.结论大部分M5白血病电镜诊断与FAB相符;MPO电镜组化可以准确地反映MPO阳性细胞在M5中的分布特点.

Objective To investigate the diagnostic result and MPO distribution claaracteristic under transmission electron microscope （TEM） on 81 cases with acute monocytic leukemia in term of FrenchAmerican-British criteria （FAB） for the diagnosis of acute monocytic leukemia, Methods Observing ultrastructure feature of leukemia cells in M5 and counting the number of MPO positive cells under electron microscope. Analyzing the diagnostic accordance of TEM with FBA and distribution of the ratio of MPO positive cells in M5. Results 59 out of 81（72.8 %） cases diagnosed by TEM accord with FAB diagnosis, but 6（19.7 %）cases are non-accordant and 6（7.4 %）cases are no diagnostic suggestion. The scope of the ratio of MPO positive cells in all M5 ranged from 0 to 100 %. The quantity of M5 in additive sequence of MPO positive cell ratio shows the bipolar distribution. Conclusion Most of eases with M5 leukemia diagnosed by TEM tally with FAB and TEM examination are more accurate in analyzing MPO distribution from Ms.