[1]聂 群,陈卓诚a,聂李平a,等.自动血细胞分析参数对骨髓增生异常综合征和再生障碍性贫血的鉴别诊断价值[J].现代检验医学杂志,2017,32(05):74-77,82.[doi:10.3969/j.issn.1671-7414.2017.05.017]
　NIE Qun,CHEN Zhuo-chenga,NIE Li-pinga,et al.Performance of Automatic Blood Cell Analysis Parameters for Differential Diagnosis of Myelodysplastic Syndromes and Aplastic Anemia[J].Journal of Modern Laboratory Medicine,2017,32(05):74-77,82.[doi:10.3969/j.issn.1671-7414.2017.05.017]
点击复制

自动血细胞分析参数对骨髓增生异常综合征和再生障碍性贫血的鉴别诊断价值()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年05期
页码:
74-77,82
栏目:
论著
出版日期:
2017-11-02

文章信息/Info

Title:
Performance of Automatic Blood Cell Analysis Parameters for Differential Diagnosis of Myelodysplastic Syndromes and Aplastic Anemia
文章编号:
1671-7414(2017)05-074-05
作者:
聂 群1; 陈卓诚2a; 聂李平2a; 周 宇2a; 张红宇2b; 李建新2a
1.深圳市大鹏新区妇幼保健院检验科,广东深圳 518120; 2.北京大学深圳医院a.检验科; b.血液科,广东深圳 518036
Author(s):
NIE Qun1; CHEN Zhuo-cheng2a; NIE Li-ping2a; ZHOU Yu2a; ZHANG Hong-yu2b; LI Jian-xin2a
1.Department of Clinical Laboratory,Dapeng New District Maternal and Children Health Hospital of Shenzhen,Guangdong Shenzhen 518120,China; 2a.Department of Clinical Laboratory; 2b.Department of Hematology,Peking University Shenzhen Hospital,Guangdong Shenzhen 518036,China
关键词:
骨髓增生异常综合征;  再生障碍性贫血;  自动血细胞分析参数;  鉴别诊断
分类号:
R55; R446.111
DOI:
10.3969/j.issn.1671-7414.2017.05.017
文献标志码:
A
摘要:
目的 探讨自动血细胞分析参数对骨髓增生异常综合征(MDS)和再生障碍性贫血(AA)的鉴别诊断价值。方法 收集北京大学深圳医院2002年12月～2011年2月确诊为MDS或AA患者的病案资料,对符合纳入标准的病例诊断当次检查的自动血细胞分析参数资料进行统计学分析,找出差异有统计学意义的血细胞分析参数,并以ROC曲线评价这些指标对MDS和AA的鉴别诊断价值。结果 33例MDS和36例AA患者被纳入研究。根据可供评估的资料,MDS患者组与AA患者组比较,平均红细胞血红蛋白浓度(MCHC)(328.58±17.24 g/L vs 342.47±18.75 g/L,n=33/36)显著减低(P=0.002 1),而单核细胞百分比(MONO%)(11.48±9.99 vs 6.94±2.50,n=32/34)、血小板分布宽度(PDW%)(13.51±4.24 vs 10.62±3.68,n=20/22)和血小板比容(PCT%)(0.11±0.10 vs 0.04±0.07,n=11/15)显著增高(P值分别为0.0202,0.0231和0.0356),其余指标两者比较差异无统计学意义。在最适cut-off值条件下,以上四个指标鉴别诊断MDS和AA的ROC曲线下面积分别为0.706(95%可信区间:0.584～0.809),0.666(0.540～0.778),0.668(0.506～0.805)和0.745(0.538～0.894); MONO%和MCHC对鉴别诊断MDS和AA有较高的特异度和阳性预测值,分别为97.06%,88.89%和93.3%,80.0%。结论 MONO%和MCHC可作为鉴别诊断MDS和AA的简单易行指标。
Abstract:
Abstract:Objective To evaluate the performance of automated blood cell analysis parameters for differential diagnosis of myelodysplastic syndromes(MDS)and aplastic anemia(AA).Methods Dataof automatic blood cell analysis parameters at diagnosis of confirmed patientswith MDS and AA from December 2002 to February 2011 in Peking University Shenzhen Hospital were retrospectively reviewed.Results 33 cases of MDS and 36 cases of AA were recruited in this study.Based on the evaluabledata,mean corpuscular hemoglobin concentration(MCHC)(328.58±17.24 g/L vs 342.47±18.75 g/L,n=33/36)was significantly lower(P=0.002 1),while monocyte percentage(MONO%)(11.48±9.99 vs 6.94±2.50,n=32/34),platelet distribution width(PDW%)(13.51±4.24 vs 10.62±3.68,n=20/22)andplatelet hematocrit(PCT%)(0.11±0.10 vs 0.04±0.07,n=11/15)were markedly higer(all P<0.05)in patients with MDS than that of AA.No significantly differences for other blood cell analysis parameters were seen between patients with MDS and AA.Under the condition of best cut-off value,areas under the ROC curve of MCHC,MONO%,PDW and PCT were 0.706(95% confidence interval:0.584～0.809),0.666(0.540～0.778),0.668(0.506～0.805)and 0.745(0.538～0.894)respectively.MONO% and MCHC had high specificities(97.06% and 88.89%)and positive predictive values(93.3% and 80.0%)for differential diagnosis of MDS from AA.Conclusion MONO% and MCHC may be used as simple indicators for differential diagnosis of MDS and AA.

参考文献/References:

[1] 中华医学会血液学分会.骨髓增生异常综合征诊断与治疗中国专家共识(2014年版)[J].中华血液学杂志,2014,35(11):1042-1048. Chinese Society of Hematology,Chinese Medical Association.Expert consensus on diagnosis and treatment of myelodysplastic syndrome(2014)[J].Chin J Hematol,2014,35(11):1042-1048.
[2] 中华医学会血液学分会红细胞疾病(贫血)学组.再生障碍性贫血诊断与治疗中国专家共识(2017年版)[J].中华血液学杂志,2017,38(1):1-5. Red Blood Cell Disease(Anemia)Group,Chinese Society of Hematology,Chinese Medical Association.Chinese expert consensus on the diagnosis and treatment of aplastic anemia(2017)[J].Chin J Hematol,2017,38(1):1-5.
[3] Orazi A,Czader MB.Myelodysplastic syndromes[J].Am J Clin Pathol, 2009,132(2):290-305.
[4] Weinzierl EP, Arber DA.The differential diagnosis and bone marrow evaluation of new-onset pancytopenia[J].Am J Clin Pathol,2013,139(1):9-29.
[5] De Zern AE,Sekeres MA.The challenging world of cytopenias:distinguishing myelodysplastic syndromes from other disorders of marrow failure[J].Oncologist,2014,19(7):735-745.
[6] Elghetany MT,Hudnall SD,Gardner FH.Peripheral blood picture in primaryhypocellular refractory anemia and idiopathic acquired aplastic anemia:an additional tool for differential diagnosis[J].Haematologica,1997,82(1):21-24.
[7] Matsui WH,Brodsky RA,Smith BD,et al.Quantitative analysis of bone marrow CD34 cells in aplastic anemia and hypoplastic myelodysplastic syndromes[J].Leukemia,2006,20(3):458-462.
[8] 吕树文,程利梅,那春龙,等.低增生性骨髓增生异常综合征的实验诊断研究[J].现代检验医学杂志,2011,26(6):114-116. L(¨overu)SW,Cheng LM,Na CL,et al.Study on the laboratory diagnosis of hypoplastic myelodysplastic syndrome[J].J Mod Lab Med,2011,26(6):114-116.

相似文献/References:

[1]张宇洋,孙雪静.骨髓穿刺涂片联合骨髓活检切片在骨髓增生异常综合征诊断中的应用[J].现代检验医学杂志,2016,31(02):139.[doi:10.3969/j.issn.1671-7414.2016.02.042]
　ZHANG Yu-yang,SUN Xue-jing.Value of Both Bone Marrow Biopsy and Smear in Diagnosis of Myelodysplastic Syndrome[J].Journal of Modern Laboratory Medicine,2016,31(05):139.[doi:10.3969/j.issn.1671-7414.2016.02.042]
[2]韩秀蕊,杨娣娣,赵 园,等.281例骨髓增生异常综合征患者染色体核型分析及临床意义的研究[J].现代检验医学杂志,2015,30(04):91.[doi:10.3969/j.issn.1671-7414.2015.04.025]
　HAN Xiu-rui,YANG Di-di,ZHAO Yuan,et al.Study on Chromosome Karyotype and Its Clinical Significance in 281 Cases of Myelodysplastic Syndromes[J].Journal of Modern Laboratory Medicine,2015,30(05):91.[doi:10.3969/j.issn.1671-7414.2015.04.025]
[3]唐元艳,张利铭,张江召,等.骨髓增生异常综合征患者染色体异常与细胞形态学的相关性分析[J].现代检验医学杂志,2017,32(06):71.[doi:10.3969/j.issn.1671-7414.2017.06.001]
　TANG Yuan-yan,ZHANG Li-ming,ZHANG Jiang-zhao,et al.Correlation between Chromosomal Abnormality and Cell Morphology with Myelodysplastic Syndrome Patients[J].Journal of Modern Laboratory Medicine,2017,32(05):71.[doi:10.3969/j.issn.1671-7414.2017.06.001]
[4]张冬梅,万顺伦,于丽华.骨髓增生异常综合征患者外周血单个核细胞中OTC4，Gli1 基因的表达及与预后的COX 回归分析[J].现代检验医学杂志,2022,37(06):58.[doi:10.3969/j.issn.1671-7414.2022.06.011]
　ZHANG Dong-mei,WANG Shun-lun,YU Li-hua.Expression of OTC4 and Gli1 Genes in Peripheral Blood Mononuclear Cells of Patients with Myelodysplastic Syndrome and Their Correlation with Prognosis by COX Regression Analysis[J].Journal of Modern Laboratory Medicine,2022,37(05):58.[doi:10.3969/j.issn.1671-7414.2022.06.011]
[5]张良子,左琴琴,吴大洲,等.1 例骨髓增生异常综合征多次受血患者血清存在抗-M，抗-cE 和抗-Jkb 抗体的鉴定及配血输血策略[J].现代检验医学杂志,2023,38(01):195.[doi:10.3969/j.issn.1671-7414.2023.01.037]
　ZHANG Liang-zi,ZUO Qin-qin,WU Da-zhou,et al.Identification and Transfusion Strategy of Anti-M，Anti-cE and Anti-Jkb Antibodies in the Serum of Patients with Myelodysplastic Syndromes Receiving Multiple Blood Transfusions[J].Journal of Modern Laboratory Medicine,2023,38(05):195.[doi:10.3969/j.issn.1671-7414.2023.01.037]
[6]曲志梅,董 伟,刘艳萍.维奈克拉增强MDS 细胞系对地西他滨化疗敏感性机制的实验研究[J].现代检验医学杂志,2023,38(03):53.[doi:10.3969/j.issn.1671-7414.2023.03.010]
　QU Zhi-mei,DONG Wei,LIU Yan-ping.Experimental Study on the Mechanism of Venetoclax Enhancing the Sensitivity of MDS Cell Lines to Decitabine Chemotherapy[J].Journal of Modern Laboratory Medicine,2023,38(05):53.[doi:10.3969/j.issn.1671-7414.2023.03.010]
[7]徐 娟a,贲海祥a,丁琳琳a,等.白细胞介素-1β 基因（rs16944）单核苷酸多态性与骨髓增生异常综合征易感性及临床特征的相关性研究[J].现代检验医学杂志,2023,38(04):51.[doi:10.3969/j.issn.1671-7414.2023.04.009]
　XU Juana,BEN Haixianga,DING Linlina,et al.Study on the Relationship between Single Nucleotide Polymorphism of Interleukin-1β (rs16944) Gene and Susceptibility and Clinical Characteristics of Myelodysplastic Syndromes[J].Journal of Modern Laboratory Medicine,2023,38(05):51.[doi:10.3969/j.issn.1671-7414.2023.04.009]
[8]杨艳敏,郝秀君,赵志芳,等.骨髓增生异常综合征患者骨髓中ABAT mRNA表达和ABAT甲基化水平对预后预测价值研究[J].现代检验医学杂志,2024,39(06):84.[doi:10.3969/j.issn.1671-7414.2024.06.014]
　YANG Yanmin,HAO Xiujun,ZHAO Zhifang,et al.Prognostic Value of ABAT mRNA Expression and ABAT Methylation Level in Bone Marrow of Patients with Myelodysplastic Syndrome[J].Journal of Modern Laboratory Medicine,2024,39(05):84.[doi:10.3969/j.issn.1671-7414.2024.06.014]

备注/Memo

备注/Memo:
基金项目:深圳市科技创新委基础研究资助项目(JCYJ20150403091443282)。 作者简介:聂 群(1982-),女,本科,主管技师,主要从事临床一般检验工作,E-mail:88009850@qq.com。 通讯作者:李建新(1968-),男,博士,主任技师,E-mail:ljxdoctor@126.com。
更新日期/Last Update: 1900-01-01