急性早幼粒细胞白血病细胞亚型的形态学特征研究

Morphological characteristics study of the subtypes of acute promyelocytic leukemia cells

目的探讨各亚型急性早幼粒细胞白血病(APL)的细胞形态学指标对诊断的意义。方法按照粗颗粒细胞百分比,以粗颗粒≥50%为粗颗粒型(M3a),粗颗粒<50%为细颗粒型(M3b),微小颗粒为变异型(M3v)对66例APL患者进行分组。观察各亚型异常早幼粒细胞形态学特征,并结合骨髓象特征进行比较分析。染色用瑞氏染料、刘氏染料。结果三种亚型早幼粒细胞百分比:M3a>M3b>M3v,而且M3v与M3a和M3b间差异有统计学意义,并且M3v型原始细胞数明显增高。内外浆、柴捆细胞及火焰状瘤样突起异常早幼粒细胞是APL最显著的形态学特征。结论细胞形态学特征对APL亚型有诊断价值。

Objective To investigate the diagnostic values of morphologic characteristics on the subtypes of acute promyelocytic leukemia（APL）. Methods Based on the percentage of APL cells with coarse granules in the cytoplasm, 66 APE patients were divided into three subtypes： coarse granule subtype （M3a）, in which≥50% of the leukemia ceils contained coarse granules, fine granule subtype （M3b）, in which 〈50% of the leukemia cells contained coarse granules, microgranular or variant subtype （M3v） , in which leukemia cells contained microgranule. The cell morphologic characteristics of unnormal promyelocytic cells of each subtypes were observed, and were carefully analyzed and combared combined with the characteristics of bone marrow smear. Results The promyelocytic cell of the three subtypes： M3a 〉 M3b 〉 M3v, and there existed distinct difference between the M3v and M3a, M3b, besides the number of original cells of M3v was the highest. Outside-in plasm cells, faggot cells and flamboyant-lump outstanding promyelocytic cells were the remarkable morphologic characteristics of APL. Conclusion The characteristics of morphology has value for the diagnosis of acute promyelocytic leukemia.