Phi小体染色方法的改良及其临床应用价值

Improvement of Phi Bodies Stain and Its Clinical Significance

本研究应用改良氢过氧化物酶(hydroperoxidase,HPO)染色法,分析探讨Phi小体形态学特征及该法的临床应用价值。对128例髓系或淋巴系肿瘤标本行改良HPO染色,观察比较各疾病组Phi小体检出率;随机双盲法选取AML69例,均以2-氨基联苯氨为底物行HPO与过氧化物酶(POX)染色,观察比较颗粒阳性率与Phi小体检出数。结果表明:Phi小体以棒状和团块状两种形态为主,棒状Phi小体粗细、长短不一,团块状Phi小体多呈椭圆形,周边光滑。在AML-M3中检出柴捆状Phi小体;棒状Phi小体在AML-M1-M5组的检出率依次为42.9%(6/14)、83.3%(15/18)、92.0%(23/25)、52.3%(11/21)、33.3%(5/15),团块状Phi小体检出率依次为28.6%(4/14)、66.7%(12/18)、11.1%(3/25)、33.3%(7/21)、20.0%(3/15)。AML-M3组棒状Phi小体检出率与(M1+M2)或(M4+M5)组比较,(M1+M2)组团块状Phi小体检出率与M3组比较,差异均具有统计学意义(p<0.05)。结论:改良后HPO染色方法简便,Phi小体检出率高,颗粒阳性显著,对AML与ALL的鉴别、AML的分型及疗效观察均具有重要参考作用。

The aim of this study was to improve the dyeing method of hydroperoxidase （HPO）, to analyze the morphologic features of Phi bodies and to evaluate the clinical application of this methed. 128 bone marrow or peripheral blood smears from patients with myeloid and lymphoid malignancies were stained by improved HPO staining. The Phi bodies were observed with detection rate of Phi bodies in different leukemias. 69 acute myeloid leukemia （AML） specimens were chosen randomly, the positive rate and the number of Phi bodies between the improved HPO and POX stain based on the same substrate of 3,3 tliaminobenzidine were compared. The results showed that the shape of bundle- like Phi bodies was variable, long or short, while the nubbly Phi bodies often presented oval and smooth. Club-like Phi bodies were found in M3. The detection rates of bundle-like Phi bodies in AML M1 - M5 were 42.9% （6/14）, 83.3% （ 15/18 ）, 92.0% （23/25）, 52.3% （ 11/21 ）, 33.3% （5/15） respectively, and those of nubbly Phi bodies were 28.6% （4/14）, 66.7% （12/18）, 11.1% （3/25）, 33.3% （7/21）, 20.0% （3/15） respectively. The detection rate of bundle- like Phi bodies in M3 was significantly higher than that in （ M1 ＋ M2 ） or （ M4 ＋ M5 ） groups. The detection rate of nubbly Phi bodies in （M1＋ M2） group was higher than that in M3 group. In conclusion, after improvement of staining method, the HPO stain becomes simple, the detection rate of Phi bodies is higher than that by the previous method, the positive granules are more obvious, and the results become stable. This improved method plays an important role in differentiating AML from ALL, subtyping AML, and evaluating the therapeutic results.