改良 Matutes 评分中包含 CD200 在慢性淋巴细胞白血病诊断中的应用。
Application of modified Matutes score containing CD200 in diagnosis of chronic lymphocytic leukemia.
机构信息
Department of Hematology, Jiangxi Pingxiang People's Hospital, Pingxiang Jiangxi 337055.
Department of Hematology, Xiangya Hospital, Central South University, Changsha 410008.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Dec 28;47(12):1689-1694. doi: 10.11817/j.issn.1672-7347.2022.220302.
OBJECTIVES
Immunophenotyping technique is a powerful tool for the diagnosis and differential diagnosis of chronic lymphocytic leukemia (CLL) and other B-cell chronic lymphoproliferative diseases (B-CLPD). CD200 is strongly expressed in CLL. This study aims to analyze the clinical value of modified Matutes score (MMS) containing CD200 in the diagnosis of CLL.
METHODS
We retrospectively analyzed 103 B-CLPD patients diagnosed from January 2020 to July 2021, including 64 CLL patients, 11 follicular lymphoma (FL) patients, 14 mantle cell lymphoma (MCL) patients, 6 marginal zone lymphoma (MZL) patients, 1 hairy cell leukemia (HCL) patient, and 7 lymphoplasmic lymphoma/Waldenstrom macroglobulinemia (LPL/WM) patients. The expression of CD markers between the CLL group and the non-CLL group was compared, and the sensitivity, specificity, and clinical consistency of MMS and Royal Marsden Hospital (RMH) immunophenotyping score system were analyzed.
RESULTS
There were significant differences in the expressions of CD5, CD23, FMC7, CD22, CD79b, CD200, and sIg between the CLL group and the non-CLL group (χ2 values were 37.42, 54.98, 30.71, 11.67, 55.26, 68.48, and 17.88, respectively, all P<0.01). When the RMH immunophenotyping score≥4, the sensitivity was 79.7%, and the specificity was 100%. When the MMS≥3, the sensitivity was 95.3%, and the specificity was 100%. The Kappa coefficient of RMH immunophenotyping system was 0.677, and the Kappa coefficient of MMS system was 0.860.
CONCLUSIONS
The MMS system containing CD200 has better sensitivity and same specificity compared with RMH immunophenotyping system, and MMS system may be more useful in the diagnosis of CLL.
目的
免疫表型技术是诊断和鉴别诊断慢性淋巴细胞白血病（CLL）和其他 B 细胞慢性淋巴增殖性疾病（B-CLPD）的有力工具。CD200 在 CLL 中强烈表达。本研究旨在分析包含 CD200 的改良 Matutes 评分（MMS）在 CLL 诊断中的临床价值。
方法
我们回顾性分析了 2020 年 1 月至 2021 年 7 月诊断的 103 例 B-CLPD 患者，包括 64 例 CLL 患者、11 例滤泡淋巴瘤（FL）患者、14 例套细胞淋巴瘤（MCL）患者、6 例边缘区淋巴瘤（MZL）患者、1 例毛细胞白血病（HCL）患者和 7 例淋巴浆细胞性淋巴瘤/华氏巨球蛋白血症（LPL/WM）患者。比较了 CLL 组与非 CLL 组之间的 CD 标志物表达，并分析了 MMS 和皇家马斯登医院（RMH）免疫表型评分系统的灵敏度、特异性和临床一致性。
结果
CLL 组与非 CLL 组之间的 CD5、CD23、FMC7、CD22、CD79b、CD200 和 sIg 的表达存在显著差异（χ2 值分别为 37.42、54.98、30.71、11.67、55.26、68.48 和 17.88，均 P<0.01）。当 RMH 免疫表型评分≥4 时，灵敏度为 79.7%，特异性为 100%。当 MMS≥3 时，灵敏度为 95.3%，特异性为 100%。RMH 免疫表型系统的 Kappa 系数为 0.677，MMS 系统的 Kappa 系数为 0.860。
结论
包含 CD200 的 MMS 系统与 RMH 免疫表型系统相比具有更好的灵敏度和相同的特异性，MMS 系统在 CLL 的诊断中可能更有用。
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