摘要
目的:探讨骨髓涂片和流式细胞术在神经母细胞瘤骨髓转移微小病灶检测中的临床应用价值。方法:回顾性分析2019年01月至2020年10月我院收治的经病理确诊为神经母细胞瘤患者126例,收集患者临床资料,特别是在治疗期间同时同部位进行骨髓穿刺行骨髓涂片和流式细胞术(flow cytometry,FCM)检测,分析两种方法在神经母细胞瘤骨髓转移检测微小病灶中的临床应用价值。结果:126例患者在此期间内共收集骨髓涂片及FCM样本各339份(同一患者多次送检)。骨髓涂片结果提示见恶性肿瘤细胞62份,未见恶性肿瘤细胞277份,阳性率18.29%;FCM提示为非造血系统来源细胞有86份,阳性率25.37%。两种方法在神经母细胞瘤骨髓转移检出率差异有统计学意义(P<0.05)。FCM阳性而骨髓涂片阴性组34份,占10.03%;FCM阴性而骨髓涂片阳性组10份,占2.95%。骨髓涂片和FCM均阳性组52份,骨髓涂片和FCM均阴性组243份,骨髓和(或)FCM阳性样本96份,总阳性率为28.32%;两种方法在诊断神经母细胞瘤患者有无骨髓转移的符合率为87.02%。两种方法联合检测较骨髓涂片形态学单一种方法阳性检出率差异有统计学意义(P<0.05)。两种方法联合检测较FCM单一种方法阳性检出率差异无统计学意义(P> 0.05)。结论:骨髓涂片和FCM检查在神经母细胞瘤患者有无骨髓转移的符合率高达为87.02%,骨髓和(或) FCM阳性样本96份,总阳性率为28.32%,FCM和骨髓涂片联合检测可提高神经母细胞瘤骨髓转移的检出率及准确率,建议临床同时行骨髓涂片和FCM微小病灶检测。
Objective:To explore the clinical application value of bone marrow smear and flow cytometry(FCM) in the detection of minimal residual bone marrow in neuroblastoma(NB).Methods:A retrospective analysis of 126 patients with neuroblastoma diagnosed pathologically in hospital from January 2019 to October 2020,collected patient clinical data, especially during the treatment period, bone marrow aspiration at the same site, bone marrow smear and flow cytometry detection.To analyze the clinical application value of two methods in the detection of small lesions in neuroblastoma bone marrow metastasis.Results:A total of 339 bone marrow smears and FCM samples were collected from 126 patients during this period time(the same patient was submitted for multiple examinations).There were 62 cases of neuroblastoma cells were detected in bone marrow smears, and 277 cases were without neuroblastoma cells, the positive rate was 18.29%,FCM indicated that there were 86 cells of non-hematopoietic system origin, the positive rate was 25.37%.Two methods had statistically significant differences in the detection rate of neuroblastoma bone marrow metastasis(P<0.05).FCM-positive bone marrow smear negative group 34,accounting for 10.03%,10 parts by FCM negative smear-positive bone marrow, accounting for 2.95%.There were 52 cases in the double positive group of bone marrow smears and FCM,243 cases in the double negative group of bone marrow smears and FCM,and 96 cases in the positive group of bone marrow and/or FCM,the total positive rate was 28.32%.The coincidence rate of two methods in diagnosing the presence or absence of bone marrow metastasis in patients with neuroblastoma was 87.02%.The combined detection of two methods had a statistically significant difference in the positive detection rate of the bone marrow smear morphology single method(P<0.05).There was no statistically significant difference in the positive detection rate between two methods of combined detection and FCM single method(P>0.05).Conclusion:The coincidence rate of bone marrow smear and FCM detection in patients with neuroblastoma with or without bone marrow metastasis is as high as 87.02%.There are 96 positive samples of bone marrow and/or FCM,with a total positive rate of 28.32%.The combined detection of FCM and bone marrow smear improve the detection rate and accuracy of neuroblastoma bone marrow metastasis.It is recommended that both bone marrow smear and FCM micro-lesion detection be performed in clinic.
作者
黄乾倩
张淑萍
沈乐园
陈跃琼
彭雄文
HUANG Qianqian;ZHANG Shuping;SHEN Leyuan;CHEN Yueqiong;PENG Xiongwen(Department of Hematology,Sun Yat-sen University Cancer Center,Guangdong Guangzhou 510060,China;Department of Laboratory Medicine,Peking University Shenzhen Hospital,Guangdong Shenzhen 518035,China;Department of Medical Examination Center,Sun Yat-sen University Cancer Center,Guangdong Guangzhou 510060,China)
出处
《现代肿瘤医学》
CAS
北大核心
2022年第5期870-875,共6页
Journal of Modern Oncology
