脾脏硬度联合流式细胞术在急性髓系白血病微小残留病监测中的意义

The Significance of Spleen Stiffness Measurement Combine with Flow Cytometry in Acute Myeloid Leukemia Minimal Residual Disease

目的探讨脾脏硬度(SSM)联合流式细胞术(FCM)在急性髓系白血病(AML)微小残留病(MRD)监测中的意义。方法选取2016年3月-2020年3月在河北中石油中心医院就诊的33例初治AML患者,治疗前作为初诊组、治疗后作为诱导化疗后组,同时选取15例健康志愿者作为对照组,分别进行SSM检测,比较各组SSM差异,进一步根据MRD水平将诱导化疗后患者分为MRD-、MRD+组,比较各组SSM差异,分析MRD+组SSM与MRD的相关性。结果初诊组SSM高于对照组、诱导化疗后组,差异有统计学意义(P<0.05);MRD+组SSM高于MRD-组,差异有统计学意义(P<0.05);MRD+组SSM与MRD水平呈正相关(r=0.877);7例患者复发时SSM升高,9例持续缓解患者SSM总体呈下降趋势。结论诱导化疗后SSM与MRD密切相关,用FS检测SSM或可联合FCM检测MRD对AML患者进行动态随访、评估预后。

Objective To explore the role of spleen stiffness measurement(SSM)combine with flow cytometry(FCM)in acute myeloid leukemia(AML)minimal residual disease(MRD)monitoring.Methods From March 2016 to March 2020,33 newly diagnosed AML patients in Hebei Petro China Central Hospital were selected.Before treatment,they were taken as the initial diagnosis group,and after treatment,they were taken as the post-induction chemotherapy group.At the same time,15 healthy volunteers were selected as the control group.SSM tests were performed to compare the differences of SSM in each group.The patients after induction chemotherapy were further divided into MRD-and MRD+groups according to the MRD level.The differences of SSM in each group were compared,and the correlation between SSM and MRD in the MRD+group was analyzed.Results The SSM of the initial diagnosis group was higher than that of the control group and the post-induction chemotherapy group,and the difference was statistically significant(P<0.05).The SSM in the MRD+group was higher than that in the MRD-group,and the difference was statistically significant(P<0.05).SSM in MRD+group was positively correlated with MRD level(r=0.877);SSM increased in 7 patients with recurrence,and decreased in 9 patients with continuous remission.Conclusion Post-induction chemotherapy SSM was strongly correlated with MRD.Combined SSM detection by using FS with MRD detection by using FCM may be used to follow up AML patients,to assess the prognosis.