摘要
目的:研究骨髓增生异常综合征(MDS)的病态造血特征,分析与MDS诊断高度相关的特异性病态造血的诊断价值。材料与方法:收集初诊MDS患者45例,对照组病例50例,通过骨髓及外周血细胞形态学、细胞化学染色分析比较各种病态造血在MDS组和对照组中的发生率、敏感性、特异性及阳性预测值等。结果:除胞浆空泡及巨核系过分叶核外,其余各种病态造血在MDS中的发生率显著高于对照组(P<0.05)。Auer小体、假Pelger-Huēt样畸形、奇数核幼红、微小巨核细胞,以及外周血原始细胞和小巨核细胞的特异性和阳性预测值为100%。其次,多核粒细胞和原始细胞>2%、环形铁粒幼细胞、多核幼红、小巨核、单圆核巨核的特异性和阳性预测值均>90%。结论:Auer小体、假Pelger-Huēt样畸形、奇数核幼红、微小巨核细胞在MDS诊断中的特异性极高,联合外周血细胞形态、细胞化学染色对MDS的诊断和鉴别诊断具有重要价值。
Purpose： To study the characteristics of dysplasia in patients with myelodysplastic syndromes （ MDS）, and to analyze the diagnostic value of MDS in the diagnosis of specific dysplasia. Materials and Methods： 45 cases of newly diagnosed MDS patients and 50 cases of control group were collected. The incidence rate, sensitivity, specificity and positive predictive value of various dysplasia cells in the MDS and control groups were compared by the bone marrow and peripheral blood cell morphology, and cytochemistry staining. Results： The incidence of all kinds of dysplasia in MDS were significantly higher than that in the control group （P 〈 0. 05 ）except for the cytoplasmic vacuoles and the excessive leaves nuclear megakaryocyte. The specificity and positive predictive value of Auer rods, pseudo Pelger-Huet, odd nuclear erythrohlasts, mieromegakaryo- eytes, and the myeloblast and small megakaryocytes of peripheral blood were 100%. Secondly, the polymorphonuelear cells and myeloblast 〉 2% , ring sideroblasts and polynuclear erythroblasts, small megakaryocytes, single round nuclear megakaryocytes, the specificity and positive predictive value were greater than 90%. Conclusion： In the diagnosis of MDS, the Auer rods, pseudo Pelger-Huet, odd nuclear erythroblasts and micromegakaryoeytes have extremely high specificity, which combined with peripheral blood cell morphology and eytoehemistry staining indicate important values in the diagnosis and differential diagnosis of MDS.
作者
陈雷
Chen Lei(Department of Clinical Laboratory, Pizhou People＇ s Hospital, Pizhou221300, Jiangsu, China)
出处
《现代医用影像学》
2016年第6期1035-1039,共5页
Modern Medical Imageology
