五参数流式积分系统在骨髓增生异常综合征中的诊断价值

Diagnostic value of five-parameter flow cytometry scoring system in myelodysplastic syndrome

建立辅助骨髓增生异常综合征(MDS)诊断的五参数流式积分系统。应用多参数流式细胞仪,在传统CD34/CD19/CD33/CD45抗体组合基础上新加CD10/CD45抗体组合,回顾性分析320例因外周血细胞减少行骨髓穿刺检查患者骨髓流式参数,分为研究组与验证组,分别用于五参数流式积分系统的建立与验证。结果显示MDS与非MDS患者之间各参数表达有差异:髓系前体细胞比例明显升高,B系前体细胞比例降低,髓系前体细胞CD45平均荧光强度表达异常,粒细胞侧向角以及CD10平均荧光强度明显降低,分别确定cut-off值,赋予符合标准者每一参数1分,建立流式积分系统,以≥2分诊断为MDS,敏感度达85.3%,特异度为87.7%,较传统四参数流式积分系统诊断准确性明显提高,因此改进的五参数流式积分系统可以更好地辅助MDS的诊断。

To develop a five-parameter flow cytometry scoring system for the diagnosis of myelodysplastic syndrome (MDS). Using multiparameter flow cytometry,added a CD10/CD45 antibody combination based on the traditional CD34/CD19/CD33/CD45 antibody combination. Bone marrow flow parameters of 320 patients with reduced peripheral blood cells were analyzed retrospectively,divided into research group and validation group,which were used for the establishment and verification of five-parameter flow cytometry scoring system. Compared with non-clonal cytopenia patients,MDS had significantly increased myeloblast-related cluster size,decreased B-progenitor-related cluster size,expression of CD45 mean fluorescence intensity was abnormal in myeloblast-related cluster,the side scatter and CD10 mean fluorescence intensity in granulocytes was reduced significantly,and determine the cut-off value,one point was given for each parameter inside the reference range,when score 2 or more was defined as positive,the sensitivity and specificity in the research group was 85.3% and 87.7% respectively. Compared with the traditional four-parameter flow cytometry system,the diagnostic accuracy was significantly improved,so the improved five-parameter flow cytometry scoring system can better assist in the diagnosis of MDS.