恶性血液病患者外周血中性粒细胞CD64指数检测方法初探

Improvement of Method for Detecting Peripheral Blood Neutrophil CD64 Index in Patients with Hematologic Malignancies

目的:改进部分恶性血液病患者的nCD64指数检测方法,提高nCD64指数在恶性血液病患者中的检出率及其准确性。方法:采用队列研究方法,对血液科病房可疑细菌感染的恶性血液病患者(255例次)进行nCD64指数检测。入组在检测过程中因异常细胞干扰而影响标本nCD64指数的检测,则通过在应用原试剂盒常规检测的基础上加入抗体CD45、CD15和CD10,以更准确地区分出中性粒细胞以进行分群,测得改良后nCD64指数。比较检测方法改良前后nCD64指数及nCD64指数、PCT、CRP对于脓毒症的诊断效力。结果:60例样本在检测过程中受到异常细胞干扰,其中18例样本因细胞分解困难导致检测失败。方法改良后18例样本均得到有效的检测结果。脓毒症组恶性血液病患者检测方法改良前后nCD64指数、PCT、CRP均高于非脓毒症组(P<0.05)。改良后nCD64指数对于脓毒症诊断效率优于PCT、CRP;改良后nCD64指数具有与改良前nCD64指数相当的诊断效率,且结果可靠性更高。结论:对于nCD64指数检测过程中受异常细胞干扰的恶性血液病患者样本,可根据患者的血液病类别加入相应抗体以更精准对外周血中性粒细胞进行设门,从而通过准确识别中性粒细胞群以提高nCD64指数检测的检出率及准确性。

Objective:To improve the method for detecting the neutrophil CD64 (nCD64) index and to enhance the detection rate and accuracy of nCD64 index in patients with hematologic malignancies. Methods:The nCD64 index in peripheral blood of patients with hematologic malignancies combined with suspicious bacterial infection (255 cases-time) was detected by using array method. When the detection of nCD64 index in samples was interfered with abnormal cells in detection process of enrolled patients,the antibodies CD45,CD15 and CD10 were added into samples on the basis of routine detection by using the primary detection kit,in order to more accurately distinguish the neutrphils and obtain the nCD64 index. The nCD64 index as well as the efficiency of nCD64 index,PCT and CRP for diagnosis of sepsis before and after the improvement of deteation method were compared. Results:The samples of 60 cases were interfered with abnormal cells in detection process,out of which the samples of 18 cases failed in detection,but these samples of 18 cases all got the effective results of detection after the detection method was improved. The detection showed that the nCD64 index before and after the improvement as well as the PCT and CRP levels in sepsis group were higher than those in nonsepsis group(P < 0.05). After improvement of method,the efficiency of nCD64 index for diagnosis of sepsis was suprior to the PCT and CRP,the nCD64 index obtained after the improvement of method possessed the diagnosis efficiency same as the efficiency obtained before improvement of method,moreover the detection results were more reliable. Conclusion:For the samples of patients with hematologic malignancies interfered with abnormal cells in the process of detecting the nCD64 index,the corresponding antibodies are added into detected samples according to the kinds of hemotologic diseases of patients,in order to more accurately gate the neutrophils in paripheral blood of patients,there by the detection rate and accuracy for detecting the nCD64 index are enhanced by accurately distinguishing the neutrophils.