不同方法学检测急性髓系白血病MPO阳性率的比较及意义
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摘要
目的比较免疫组化、细胞化学及流式细胞学3种方法检测急性髓系白血病(AML)胞内MPO阳性率的差异及临床意义。方法对90例AML患者同时进行骨髓活检组织免疫组织化学染色,细胞涂片细胞化学染色及骨髓流式细胞学分析,检测MPO表达情况。结果 3种方法联合检测,AML患者MPO总阳性率为95. 5%,其中免疫组织化学、细胞化学及流式细胞学方法检测MPO阳性率分别为66. 7%、93. 3%及87. 8%,以免疫组化方法检测MPO敏感度最低,明显低于细胞化学和流式细胞学检测方法(P均<0. 05),而细胞化学与流式细胞学法比较,MPO表达率差异无统计学意义(P> 0. 05); AML患者中,除M7外,以M5患者MPO阳性率最低(88. 9%),其中免疫组织化学法MPO的检出率最低(37. 0%),明显低于细胞化学法(88. 9%,P <0. 05),但与流式细胞学方法比较,差异无统计学意义(P> 0. 05)。结论细胞化学及流式细胞术检测AML患者MPO表达的阳性率优于活检组织的免疫组化法,三者结合比单独一种更有利于AML与急性淋巴细胞白血病的鉴别诊断。
Objective To compare the difference of immunohistochemistry,cytochemistry and flow cytometry methods in detecting the expression of MPO in acute myeloid leukemia( AML) and its clinical significance. Methods The immunohistochemistry,cytochemistry and flow cytometry technique were used for detecting the MPO expression. Results The total positive rate of MPO by the three methods was 95. 5%. The positive rates of MPO by immunohistochemistry,cytochemistry and flow cytology were 66. 7%,93. 3% and 87. 8%,respectively. The sensitivity of MPO detection by immunohistochemical method was the lowest,and the positive rate of MPO detected by immunohistochemical method was significantly lower than that of cytochemistry and flow cytology( P < 0. 05),but there was no significant difference in the positive rate of MPO between cytochemistry and flow cytometry( P > 0. 05). Except for M7 subtype,the positive rate of MPO in M5 patients was the lowest( 88. 9%),and the positive rate of MPO by immunohistochemistry was the lowest( 37. 0%),which was significantly lower than that by cytochemical method( 88. 9%,P < 0. 05),but there was no significant difference compared with flow cytology( P > 0. 05). Conclusion The cytochemistry and flow cytometry MPO positive rate in patients with AML was better than that of immunohistochemistry,and the combination of the three methods was more beneficial to the differential diagnosis of AML from acute lymphoblastic leukemia than that of single one.
Objective To compare the difference of immunohistochemistry,cytochemistry and flow cytometry methods in detecting the expression of MPO in acute myeloid leukemia( AML) and its clinical significance. Methods The immunohistochemistry,cytochemistry and flow cytometry technique were used for detecting the MPO expression. Results The total positive rate of MPO by the three methods was 95. 5%. The positive rates of MPO by immunohistochemistry,cytochemistry and flow cytology were 66. 7%,93. 3% and 87. 8%,respectively. The sensitivity of MPO detection by immunohistochemical method was the lowest,and the positive rate of MPO detected by immunohistochemical method was significantly lower than that of cytochemistry and flow cytology( P < 0. 05),but there was no significant difference in the positive rate of MPO between cytochemistry and flow cytometry( P > 0. 05). Except for M7 subtype,the positive rate of MPO in M5 patients was the lowest( 88. 9%),and the positive rate of MPO by immunohistochemistry was the lowest( 37. 0%),which was significantly lower than that by cytochemical method( 88. 9%,P < 0. 05),but there was no significant difference compared with flow cytology( P > 0. 05). Conclusion The cytochemistry and flow cytometry MPO positive rate in patients with AML was better than that of immunohistochemistry,and the combination of the three methods was more beneficial to the differential diagnosis of AML from acute lymphoblastic leukemia than that of single one.
引文
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2 Arber DA,Orazi A,Hasserjian R,et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia[J]. Blood,2016,127(20):2391-2405
3 Lee EJ,Pollak A,Leavitt RD,et al. Minimally differentiated acute nonlymphocytic leukemia:a distinct entity[J]. Blood,1987,70(5):1400-1406
4 Eguchi M,Mikami T,Kurosawa H,et al. Electron microscopic and cytochemical studies of peroxidase-negative acute nonlymphoblastic leukemia[J]. Med Electron Microsc,2001,34(1):61-70
5 Kaleem Z,Crawford E,Pathan MH,et al. Flow cytometric analysis of acute leukemias. Diagnostic utility and critical analysis of data[J].Arch Pathol Lab Med,2003,127(1):42-48
6 常军林,巨小英.髓过氧化物酶染色对急性白血病分型诊断的价值[J].吉林医学,2014,35(22):4925-4926