Ahuja Ankur, Tyagi Seema, Seth Tulika, Pati Hara Prasad, Gahlot Gps, Tripathi Preeti, Somasundaram Venkatesan, Saxena Renu
1Department of Lab Sciences and Molecular Medicine, Army Hospital (Research and Referral), New Delhi, India.
2Department of Haematology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Hematol Blood Transfus. 2018 Apr;34(2):233-239. doi: 10.1007/s12288-017-0849-1. Epub 2017 Jul 28.
Acute Myeloid Leukemia (AML) as per World Health Organization (WHO 2008) classification is on the basis of the antigenic characterization, enzymes restriction in the neoplastic myeloid cells and the specific translocations/mutations. AML can be assessed and differentiated by flowcytometry (FCM)/immunohistochemistry (IHC)/cytochemistry techniques. Myeloperoxidase (MPO) is an unequivocal marker to differentiate AML from the acute lymphoblastic leukemia. Despite FCM popularity, it has its limitations, in form of 'dry-tap', cost, and inability of being performed by retrospective analysis. IHC, though an old technique has overcome these disadvantages of FCM. Cytochemistry, on the other hand has its own advantages in being cost-effective; technically easy to do while its disadvantages are its inability to be carried out in the old samples, 'dry-tap' conditions in aleukemic leukemia. There has been non-uniformity in the literature among these techniques especially concerning their sensitivity for MPO. A prospective study was done at All India Institute of Medical Sciences New Delhi from 01 July 2014 to 30 Nov 2015 to include 120 diagnosed acute myeloid leukemia cases. Myeloperoxidase stain was done by cytochemistry, immunohistochemistry and flow cytometry and results were compared. There were 28 cases which showed discrepancies. Out of these 28 cases immunohistochemistry showed positivity in majority (22 cases) followed by flow cytometry (14 cases). Therefore it is important to employ more than one technique and IHC must be included for detection of MPO in all suspected cases of AML especially when negative with FCM .
根据世界卫生组织（2008年）的分类，急性髓系白血病（AML）基于肿瘤性髓系细胞的抗原特征、酶限制以及特定的易位/突变。AML可通过流式细胞术（FCM）/免疫组织化学（IHC）/细胞化学技术进行评估和鉴别。髓过氧化物酶（MPO）是区分AML与急性淋巴细胞白血病的明确标志物。尽管FCM很常用，但它存在局限性，如“干抽”、成本高以及无法进行回顾性分析。IHC虽是一项旧技术，但克服了FCM的这些缺点。另一方面，细胞化学具有成本效益高、技术操作简便的优点，但其缺点是无法在陈旧样本中进行，在无白血病性白血病中存在“干抽”情况。这些技术在文献中的报道并不一致，尤其是它们对MPO的敏感性。2014年7月1日至2015年11月30日在新德里全印度医学科学研究所进行了一项前瞻性研究，纳入120例确诊的急性髓系白血病病例。通过细胞化学、免疫组织化学和流式细胞术进行髓过氧化物酶染色，并比较结果。有28例出现差异。在这28例中，免疫组织化学显示阳性的居多（22例），其次是流式细胞术（14例）。因此，在所有疑似AML病例中，尤其是FCM检测为阴性时，采用多种技术进行检测很重要，并且必须包括免疫组织化学来检测MPO。
