流式细胞术用于白血病外周血细胞检测对急性白血病复发判断的意义

Peripheral blood cell determination for acute leukemia recurrence by flow cytometry

目的探讨流式细胞术(FCM)用于白血病外周血细胞检测对急性白血病(AL)预后的评估价值。方法采用FCM检测142例AL患者的外周血标本,同时做骨髓细胞形态学检验。分析FCM在急性髓系白血病(AML)和急性淋巴白血病(ALL)检验中的敏感性及特异性。随访12个月,分析外周血微小残留病变(MRD)阳性、阴性与复发率的关系。结果 AML患者88例,FCM检测的敏感性为96.6%,特异性为33.3%;ALL患者54例,FCM检测的敏感性为88.9%,特异性为44.4%。24例MRD阴性患者中有6例复发,复发率为25.0%;118例MRD阳性患者中有88例复发,复发率为74.6%,MRD阳性患者复发率显著高于阴性患者(P<0.05)。结论 FCM检测AL患者外周血细胞具有较好的敏感性,在AL复发率评估中有一定的临床意义。

Objective To investigate the performance of flow cytometry(FCM)in peripheral blood cell determination in patients with acute leukemia(AL).Methods A total of 142 patients with AL were enrolled.Their peripheral blood samples were determined by FCM.The morphological changes of bone marrow cells were determined as well,and the results were used as standard.The sensitivities and specificities of FCM for acute myeloid leukemia(AML)and acute lymphoblastic leukemia(ALL)were evaluated.The follow-up period was 12 months.The relationship of the positive rate and the negative rate of microresidual disease(MRD)with recurrence rate in peripheral blood was analyzed.Results There were 88 cases of AML,and the sensitivity and specificity of FCM were 96.6%and 33.3%,respectively.There were 54 cases of ALL,and the sensitivity and specificity of FCM were 88.9%and 44.4%,respectively.Among the 24 patients with negative MRD,6 patients had recurrence,and the recurrence rate was 25.0%.There were 88 of 118 positive MRD patients with recurrence,and the recurrence rate was 74.6%.The recurrence rate of positive MRD patients was higher than that of negative MRD patients(P<0.05).Conclusions FCM has a good sensitivity in peripheral blood cell determination in patients with of AL and in the evaluation of AL recurrence.