摘要
目的 探讨流式细胞术检测急性髓细胞性白血病 (AML)微小残留病变 (MRD)的临床意义。方法 以正常人和 5 3例AML完全缓解 (CR)的患者为对象 ,采用双色直接免疫荧光标记及多参数流式细胞术检测外周血中MRD ,并与传统的骨髓形态学结果进行比较。结果 预测各组患者发生复发的敏感性和特异性分别为 :CR≤ 1年组为 10 0 %(8/ 8)和 4 2 .9% (3/ 7) ,1年 <CR≤ 3年组为 10 0 % (5 / 5 )和 75 % (6 / 8) ,CR >3年组为 5 0 % (1/ 2 )和 95 .6 % (2 2 / 2 3) ,对所有第 1次受检MRD为阳性随后确认为复发的患者 ,比骨髓象诊断复发平均提前 7个月。结论 该方法快速、简单 ,对患者创伤小 ,可比传统骨髓形态学更早提示复发 ,尤其是采取连续性定期监测、动态观察的方式 ,会进一步增加检测结果的准确性 ,为临床防止复发、选用个体化治疗方案提供有效的实验依据。
Objective To investigate the clinical significance of examining the minimal residual disease (MRD) by flow cytometry in 53 cases with AML.Methods The specimens for test were peripheral blood from healthy persons and patients with AML in complete remission. The assay of MRD were made by using the double direct immunofluorescence labeling and multy-parameter flow cytometry technology. At last the results were compared with traditional bone marrow cells morphology.Results The sensibitity and specificity to predict relapse of patients in various group are as follows respectively :The group of CR≤1 year are 100%(8/8) and 42.9% (3/7),The group of 1 year<CR≤3years are 100% (5/5) and 75% (6/8),The group of CR>3 years are 50% (1/2) and 95.6% (22/23). The results of MRD positive can earlier predict relapse than the traditional bone marrow cells morphology assay by an average of 7 months.Conclusion This method is very simple, fast and mini-traumatic to patient, especially by means of continuous and regular monitoring and dynamic analyse can further improve the accuracy. It is able to provide strong evidence for predict relapse and select individualized treatment in clinic.
出处
《中国实验诊断学》
2003年第5期383-385,共3页
Chinese Journal of Laboratory Diagnosis
基金
1998年安徽省自然科学基金 (9842 2 12 8)
2001年安徽省优秀青年科研基金资助
