Promsuwicha Orathai, Kankhao Supattra, Songmuang Wayuree, Auewarakul Chirayu U
J Med Assoc Thai. 2014 Dec;97(12):1296-301.
Diagnosis of hematologic malignancies requires a multidisciplinary approach. Flow cytometry (FCM) has become an essential tool for immunophenotypic studies of malignant hematopoietic cells.
To evaluate the utilization trend of FCM and its diagnostic yields for hematologic malignancy at a major teaching hospital in Thailand.
FCM results of bone marrow (BM) and peripheral blood (PB) specimens during 2000-2013 were analyzed and compared to clinical diagnosis.
Overall, 7,982 specimens were submitted for diagnostic FCM including 6,561 BM and 1,421 PB. The number of specimens analyzedwas 121, 142, 164, 299, 491, 431, 690, 611, 719, 744, 725, 863, 955 and 1,027, respectively, from 2000 to 2013. The most common clinical diagnoses requested for FCM were acute leukemia (5,911 cases, 74%) followed by lymphoma (1,419 cases, 17.8%), and chronic lymphocytic leukemia (CLL) (634 cases, 7.94%). The highest diagnostic yield of FCM was found in acute leukemia cases (69.71%) followed by CLL (35.33%). Only 15.43% of clinically suspected lymphoma cases were positive by FCM. Overutilization of PB (35.6% of cases) instead of BM for lymphoma staging significantly contributed to low diagnostic yields of lymphoma by FCM as circulating tumor cells may not be present in such cases.
FCM has an increasing role in the diagnosis of hematologic malignancies in Thai patients over the past 14 years with the highest diagnostic yield in acute leukemia. Appropriate specimen types and study indications are required in order to reduce futility of costly diagnostic tests and improve diagnostic yields.
血液系统恶性肿瘤的诊断需要多学科方法。流式细胞术（FCM）已成为恶性造血细胞免疫表型研究的重要工具。
评估泰国一家主要教学医院FCM的使用趋势及其对血液系统恶性肿瘤的诊断率。
分析2000 - 2013年期间骨髓（BM）和外周血（PB）标本的FCM结果，并与临床诊断进行比较。
总体而言，共提交7982份标本进行诊断性FCM检测，其中6561份为骨髓标本，1421份为外周血标本。2000年至2013年每年分析的标本数量分别为121、142、164、299、491、431、690、611、719、744、725、863、955和1027份。FCM检测最常见的临床诊断请求是急性白血病（5911例，74%），其次是淋巴瘤（1419例，17.8%）和慢性淋巴细胞白血病（CLL）（634例，7.94%）。FCM诊断率最高的是急性白血病病例（69.71%），其次是CLL（35.33%）。临床疑似淋巴瘤病例中，FCM检测阳性的仅占15.43%。在淋巴瘤分期时过度使用外周血（35.6%的病例）而非骨髓标本，显著导致FCM对淋巴瘤的诊断率较低，因为此类病例中可能不存在循环肿瘤细胞。
在过去14年中，FCM在泰国患者血液系统恶性肿瘤诊断中的作用日益增加，其中急性白血病的诊断率最高。为减少昂贵诊断检查的无效性并提高诊断率，需要合适的标本类型和研究指征。
