Zhang Ke-Jie, Lu Quan-Yi, Li Pu, Zhang Peng, Niu Xiao-Qing
Department of Hematology, Xiamen University Zhongshan Hospital, Fujian Medical University Clinical Teaching Hospital, Xiamen 361004, Fujian Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2010 Aug;18(4):972-5.
This study was purposed to explore the clinical application of mean platelet volume (MPV), platelet distribution width (PDW), platelet-large cell ratio (P-LCR), lactate dehydrogenase (LDH) level in the differential diagnosis of thrombocytosis. The clinical applications of 3 platelet routine laboratory parameters (MPV, PDW, P-LCR) and LDH were examined in 1048 patients with thrombocytosis-related diseases: reactive thrombocytosis (RT), chronic myeloproliferative disease (CMPD) including chronic myeloid leukemia (CML), essential thrombocythemia (ET) and polycythemia vera (PV). Receiver operating characteristic (ROC) curve was used to predict the cause of thrombocytosis. The results indicated that there were significant differences in MCV, PDW, P-LCR and LDH level between RT and CMPD groups (p < 0.05). The area under ROC curve of PDW and P-LCR for prediction of CMPD were 0.96 (95% CI: 0.93 - 0.99) and 0.89 (95% CI: 0.84 - 0.95) respectively, and whose optimal cut-off value was 11.95%and 23.05% respectively. Three types of CMPD were characterized as follows: high P-LCR and high LDH level in chronic myeloid leukemia, whose optimal cut-off value was 424 U/L and 26.10% respectively; slightly high LDH level and high Plt count in ET, the optimal cut-off value of Plt was 939 x 10⁹/L. In conclusion, these characteristics of MPV, PDW, P-LCR and LDH levels may be useful for simple and primary differential diagnosis of the thrombocytosis-related disease mentioned above.
本研究旨在探讨平均血小板体积(MPV)、血小板分布宽度(PDW)、血小板大细胞比率(P-LCR)、乳酸脱氢酶(LDH)水平在血小板增多症鉴别诊断中的临床应用。对1048例血小板增多症相关疾病患者进行了3项血小板常规实验室参数(MPV、PDW、P-LCR)及LDH的临床应用研究,这些疾病包括反应性血小板增多症(RT)、慢性骨髓增殖性疾病(CMPD),后者包括慢性粒细胞白血病(CML)、原发性血小板增多症(ET)和真性红细胞增多症(PV)。采用受试者工作特征(ROC)曲线预测血小板增多症的病因。结果表明,RT组与CMPD组之间的MCV、PDW、P-LCR及LDH水平存在显著差异(p<0.05)。PDW和P-LCR预测CMPD的ROC曲线下面积分别为0.96(95%CI:0.93 - 0.99)和0.89(95%CI:0.84 - 0.95),其最佳截断值分别为11.95%和23.05%。三种类型的CMPD具有以下特征:慢性粒细胞白血病中P-LCR及LDH水平较高,其最佳截断值分别为424 U/L和26.10%;ET中LDH水平略高且血小板计数高,血小板的最佳截断值为939×10⁹/L。总之,MPV、PDW、P-LCR及LDH水平的这些特征可能有助于对上述血小板增多症相关疾病进行简单的初步鉴别诊断。