Ahmad Nishat, Kumari Nisha, Tirkey Deepali, Mahto Sunil K, Jawaid Moazzam
Pathology, Rajendra Institute of Medical Sciences, Ranchi, IND.
Oral Medicine and Radiology, Sarjug Dental College and Hospital, Darbhanga, IND.
Cureus. 2024 Feb 13;16(2):e54126. doi: 10.7759/cureus.54126. eCollection 2024 Feb.
Leukaemia can be reliably diagnosed and classified by the simultaneous application of multiple techniques. Cytochemical stains that are cheap and do not require any special instruments are very important in developing countries for the diagnosis of acute leukaemia (AL).
To diagnose AL in all suspected cases by flow cytometry and to correlate the diagnosis with morphological and special staining like myeloperoxidase (MPO) and periodic acid-Sciff (PAS) techniques. Methods and materials: The study participants' peripheral blood smear details and bone marrow aspirate smear morphologic findings, as well as socio-demographic information, were taken from the patients' medical files. In total, 57 newly diagnosed instances of acute leukaemia confirmed by flow cytometry were incorporated into the study, which underwent cytochemical labeling and morphological diagnosis. All patients who gave previous consent had their bone marrow aspirated, and a Wright-stained smear was produced for microscopic inspection, cytochemical staining, and immunophenotyping. In an ethylenediaminetetraacetic acid (EDTA) container, peripheral blood was also drawn for the same purpose. During the entire bone marrow smear examination, we used both MPO and PAS staining techniques.
The study was carried out between July 2019 and June 2020. Out of 57 cases in the study, 29 (50.9%) cases on cytochemical analysis of leukaemia using PAS and MPO were diagnosed with acute myeloid leukaemia (AML) and 28 (49.1%) were diagnosed as acute lymphoid leukaemia (ALL). Cytochemical analysis of leukaemia using PAS and MPO rendered the diagnosis in 92.9% of acute leukaemia cases in our study. A total of 25 out of 25 AML cases and 28 out of 32 cases of ALL were correctly diagnosed based on morphology and cytochemical staining. Morphology and cytochemical analysis alone were unable to correctly diagnose a total of four ALL cases. All AML cases that were wrongly diagnosed as ALL were mostly M0 and M1-AML.
Morphological staining diagnosis by itself is capable of correctly identifying a large proportion of cases of AL, which comprised 92.98% of total cases. There was also a favorable relationship between findings of diagnosis by flow cytometry and findings of diagnosis by morphology assessment in determining acute leukaemias.
通过同时应用多种技术能够可靠地诊断和分类白血病。在发展中国家，对于急性白血病（AL）的诊断而言，廉价且无需任何特殊仪器的细胞化学染色非常重要。
通过流式细胞术诊断所有疑似病例的急性白血病，并将诊断结果与形态学以及髓过氧化物酶（MPO）和过碘酸 - 希夫（PAS）等特殊染色技术相关联。
从患者的病历中获取研究参与者的外周血涂片细节、骨髓穿刺涂片形态学结果以及社会人口统计学信息。本研究纳入了57例经流式细胞术确诊的新诊断急性白血病病例，这些病例均接受了细胞化学标记和形态学诊断。所有先前已同意的患者均进行了骨髓穿刺，并制作了瑞氏染色涂片用于显微镜检查、细胞化学染色和免疫表型分析。同样，为了相同目的，在乙二胺四乙酸（EDTA）容器中采集外周血。在整个骨髓涂片检查过程中，我们使用了MPO和PAS染色技术。
该研究于2019年7月至2020年6月期间进行。在研究的57例病例中，使用PAS和MPO对白血病进行细胞化学分析时，29例（50.9%）被诊断为急性髓系白血病（AML），28例（49.1%）被诊断为急性淋巴细胞白血病（ALL）。在我们的研究中，使用PAS和MPO对白血病进行细胞化学分析在92.9%的急性白血病病例中得出了诊断结果。基于形态学和细胞化学染色，25例AML病例中的25例以及32例ALL病例中的28例被正确诊断。仅靠形态学和细胞化学分析未能正确诊断总共4例ALL病例。所有被误诊为ALL的AML病例大多为M0和M1型AML。
形态学染色诊断本身能够正确识别大部分AL病例，占总病例数的92.98%。在确定急性白血病时，流式细胞术诊断结果与形态学评估诊断结果之间也存在良好的相关性。
