淋巴细胞参数在筛选淋巴细胞增殖及反应性增生疾病中的应用

Application of lymphocyte parameters in screening lymphocyte proliferation and reactive hyperplasia disease

目的探讨淋巴细胞参数在淋巴细胞增殖及反应性增生疾病筛查中的应用。方法选取健康对照组128例、淋巴瘤患者100例、多发性骨髓瘤(MM)患者35例、淋巴细胞反应性增生(RL)患者34例、慢性淋巴细胞白血病(CLL)患者5例。分别用Sysmex XE-2100血液分析仪进行外周血血细胞分析,记录相应淋巴细胞参数值,并对其进行疾病组与对照组差异比较分析;以受试者操作特性曲线(ROC曲线)评价各淋巴细胞参数在筛选淋巴细胞增殖及反应性增生疾病患者中的作用。结果高荧光淋巴细胞(HFL):对照组0.008±0.008,淋巴瘤组0.016±0.058,MM组0.019±0.063,RL组0.040±0.070,CLL组0.388±0.158,RL组和CLL组与对照组比较,差异有统计学意义(P<0.05);淋巴细胞百分率(LY%):对照组34.4%±5.9%,淋巴瘤组26.6%±13.1%,MM组31.0%±13.1%,RL组29.2%±15.4%,CLL组44.5%±38.5%,淋巴瘤组与对照组比较,差异有统计学意义(P<0.001);淋巴细胞结构参数-X(LY-X):对照组833.5±22.7,淋巴瘤组867.9±28.5,MM组867.9±26.6,RL组859.2±27.8,CLL组894.0±65.4,除CLL组外各组与对照组比较,差异有统计学意义(P<0.001);淋巴细胞结构参数-Y(LYY):对照组659.6±23.0,淋巴瘤组669.4±43.5,MM组665.9±37.1,RL组665.9±40.0,CLL组778.4±152.1,淋巴瘤组与对照组比较,差异有统计学意义(P<0.05)。LY-X筛选淋巴细胞增殖及反应性增生疾病患者ROC曲线AUC=0.819,截断值(cutoff值)为842.5时敏感度为80.5%,特异度为60.1%。结论淋巴细胞参数,尤其是LY-X能敏感地反应淋巴细胞的形态变化,有助于筛选淋巴细胞增殖及反应性增生疾病患者。

Objective To investigate the application of lymphocyte parameters in screening the lymphocyte proliferation and re-active hyperplasia disease.Methods 128 cases as the healthy control,100 cases of lymphoma,35 cases of multiple myeloma（MM）, 34 cases of lymphocytes reactive hyperplasia（RL）and 5 cases of chronic lymphocytic leukemia（CLL）were selected and performed the peripheral blood cells analysis by the Sysmex XE-2100 hematology analyzer.The relevant lymphocyte parameter values were re-corded and the comparative analysis in the difference between the disease groups and the control group was performed.The role of each lymphocyte parameter in screening the lymphocyte proliferation and reactive hyperplasia diseases was evaluated by the receiver operating characteristic curve（ROC curve）.Results The high fluorescence lymphocytes（HFL）,in the control group was 0.008 ± 0.008,in the lymphoma group was 0.016±0.058,in the MM group was 0.019 ±0.063,in the RL group was 0.040 ±0.070,and CLL group was 0.388±0.158.Compared with control group,the difference of RL and CLL group was statistically significant（P morphological changes of lymphocytes sensitively and contribute to screening the patients with lymphocyte proliferation and reactive hyperplasia disease.