五项技术联检对骨髓增生异常综合征诊断价值的初步探讨

Diagnostic Value of Combined Examination Using 5 Technigues for Myelodysplastic Syndrome

目的:初步探讨外周血涂片、骨髓涂片、骨髓活检、染色体核型显带分析和流式细胞术(flow cytometry,FCM)5项检测技术单用和联检对骨髓增生异常综合征(myelodysplastic syndrome,M DS)的诊断意义。方法:2013年5月至2015年5月在我院经细胞学、遗传学等检测,并根据WHO造血和淋巴组织肿瘤分类的标准确诊为M DS的患者105例,分析使用2种检测技术(外周血涂片+骨髓涂片)、3种检测技术(外周血涂片+骨髓涂片+骨髓活检)、4种检测技术(外周血涂片+骨髓涂片+骨髓活检+染色体)和5种检测技术(外周血涂片+骨髓涂片+骨髓活检+染色体+流式细胞术)的MDS诊断符合率,评估预后情况。结果:在105例已确诊的MDS患者中,2种检测技术诊断符合率为70.48%,而3和4种检测技术的诊断符合率分别为83.81%、84.76%,5种检测技术联合使用诊断符合率可高达93.33%,均高于两种检测技术(P<0.05)。结论:5种检测技术各有长短,联合应用能互相补充,提高M DS诊断的准确性。

Objective:To investigate the potential value of combined examinations of peripheral blood smear,bone marrow smear,bone marrow biopsy,chromosome banding analysis and flow cytometry(FCM) in the diagnoisis of myelodysplastic syndromes.Methods:A total of 105 MDS patients who were admitted in our hospital from May 2013 to May 2015 and were diagnosed as MDS according to the criteria formulated by WHO were enrolled in this study.The accordance rate of diagnosis by the double test(peripheral blood smear plus bone marrow smear),triple test(above mentioned 2 tests plus bone marrow biopsy),quadruple test(above 3 tests plus chromosome banding analysis),and quintuple test(above 4 plus FCM) was amalyzed and compared.Results:Among the 105 MDS patients,the diagnosis accordance rate was 70.48%for double tests,while 83.81%,84.76%and 93.33%for triple,quadruple and quintuplet tests,respectively which were significantly higher than that for double tests(peripheral blood smear plus bone marrow smear)(P < 0.05).Conclusion:The combined examination of the 5 methods can improve the accuracy of MDS diagnosis.