Stachurski Dariusz, Smith Brian R, Pozdnyakova Olga, Andersen Mary, Xiao Zhefu, Raza Azra, Woda Bruce A, Wang Sa A
Department of Pathology, UMass Memorial Medical Center, University of Massachusetts, Worcester, MA, USA.
Leuk Res. 2008 Feb;32(2):215-24. doi: 10.1016/j.leukres.2007.06.012. Epub 2007 Aug 1.
Published data on flow cytometry (FCM) in diagnosing myelodysplastic syndromes (MDS) varies greatly in analytic methods and interpretational approaches. We tested the diagnostic utility of the pattern recognition approach by a retrospective review of 180 MDS, 31 myelodysplastic/myeloproliferative disease (MDS/MPD), 37 non-MDS cytopenia and 20 myeloproliferative disease (MPD) cases. Cases were placed into "positive", "intermediate", and "negative" FCM categories based upon the antigenic aberrations observed on myelomonocytic cells. By exclusion or inclusion of the intermediate category as indicative of MDS or MDS/MPD, the overall sensitivity and specificity were 84% and 97% or 98% and 78%, respectively. The overall abnormalities detected by FCM correlated with the severity of morphological dysplasia and clonal cytogenetic abnormalities. MPD also demonstrated immunophenotypic aberrancy. Based on a global evaluation of myelomonocytic abnormalities, and recognition of diagnostic pitfalls and caveats, the pattern recognition approach of FCM is sensitive and reliable in diagnosing MDS and related myeloid diseases.
关于流式细胞术（FCM）在诊断骨髓增生异常综合征（MDS）方面已发表的数据，在分析方法和解释方法上差异很大。我们通过回顾性分析180例MDS、31例骨髓增生异常/骨髓增殖性疾病（MDS/MPD）、37例非MDS血细胞减少症和20例骨髓增殖性疾病（MPD）病例，测试了模式识别方法的诊断效用。根据在骨髓单核细胞上观察到的抗原异常，将病例分为FCM“阳性”、“中间”和“阴性”类别。通过将中间类别排除或纳入作为MDS或MDS/MPD的指示，总体敏感性和特异性分别为84%和97%或98%和78%。FCM检测到的总体异常与形态学发育异常的严重程度和克隆性细胞遗传学异常相关。MPD也表现出免疫表型异常。基于对骨髓单核细胞异常的全面评估，以及对诊断陷阱和注意事项的认识，FCM的模式识别方法在诊断MDS和相关髓系疾病方面是敏感且可靠的。
