流式细胞术在骨髓增生异常综合征诊断中的诊断意义。
Diagnostic significance of flow cytometry scales in diagnostics of myelodysplastic syndromes.
机构信息
Laboratory of Immunophenotyping, National Research Center for Hematology, Moscow, Russia.
Chemotherapy Department for Hemoblastoses, Hemopoiesis Depression and BMT, National Research Center for Hematology, Moscow, Russia.
出版信息
Cytometry B Clin Cytom. 2021 May;100(3):312-321. doi: 10.1002/cyto.b.21965. Epub 2020 Oct 14.
BACKGROUND
Myelodysplastic syndromes (MDS) can present a challenge for clinicians. Multicolor flow cytometry (MFC) can aid in establishing a diagnosis. The aim of this study was to determine the optimal MFC approach for MDS.
METHODS
The study included 102 MDS (39 low-grade MDS), 83 cytopenic patients without myeloid neoplastic disorders (control group), and 35 healthy donors. Bone marrow was analyzed using a six-color MFC. Analysis was conducted according to the "Ogata score," "Wells score," and the integrated flow cytometry (iFC) score.
RESULTS
The respective sensitivity and specificity values were 77.5% and 90.4% for the Ogata score, 79.4% and 81.9% for the Wells score, and 87.3% and 87.6% for the iFC score. Specificity was not 100% due to deviations of MFC parameters in the control group. Patients with paroxysmal nocturnal hemoglobinuria (PNH) had higher levels of CD34 CD7 myeloid cells than donors. Aplastic anemia and PNH were characterized by a high proportion of CD56 cells among CD34 precursors and neutrophils. The proportion of MDS-related features increased with the progression of MDS. The highest number of CD34 blasts was found in MDS with excess blasts. MDS with isolated del(5q) was characterized by a high proportion of CD34 CD7 cells and low granularity of neutrophils. In 39 low-grade MDS, the sensitivities were 53.8%, 61.5%, and 71.8% for Ogata score, Wells score, and iFC, respectively.
CONCLUSION
The results support iFC as a useful diagnostic tool in MDS.
背景
骨髓增生异常综合征（MDS）可能对临床医生构成挑战。多色流式细胞术（MFC）可辅助诊断。本研究旨在确定 MDS 的最佳 MFC 方法。
方法
该研究纳入了 102 例 MDS（39 例低级别 MDS）、83 例无髓系肿瘤疾病的血细胞减少患者（对照组）和 35 名健康供体。采用六色 MFC 分析骨髓。根据“Ogata 评分”、“Wells 评分”和整合流式细胞术（iFC）评分进行分析。
结果
Ogata 评分的敏感性和特异性分别为 77.5%和 90.4%，Wells 评分分别为 79.4%和 81.9%，iFC 评分分别为 87.3%和 87.6%。由于对照组 MFC 参数存在偏差，特异性未达到 100%。阵发性睡眠性血红蛋白尿症（PNH）患者的 CD34 CD7 髓系细胞水平高于供体。再生障碍性贫血和 PNH 的特点是 CD34 前体细胞和中性粒细胞中 CD56 细胞比例较高。MDS 相关特征的比例随 MDS 的进展而增加。伴过多原始细胞的 MDS 中发现的 CD34 blast 数量最多。孤立性 del(5q) MDS 的特点是 CD34 CD7 细胞比例较高，中性粒细胞粒度较低。在 39 例低级别 MDS 中，Ogata 评分、Wells 评分和 iFC 的敏感性分别为 53.8%、61.5%和 71.8%。
结论
结果支持 iFC 作为 MDS 的一种有用的诊断工具。
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