评估NPM1基因突变的急性髓系白血病患者实验室检测结果的预后价值

目的分析NPM1基因突变急性髓系白血病(NPM1mutAML)患者的临床与实验室检测结果, 探索预后影响因素。方法选择2012 年 5 月1日至 2021年 12 月31日在河北燕达陆道培医院就诊的伴有NPM1mutAML患者77例(男34例, 女43例), 年龄40(3, 68)岁, 按照形态学法美英(FAB)分型分成4组, M1型29例(37.7%), M2型13例(16.9%), M4型23例(29.9%), M5型12例(15.5%)。回顾性分析不同组别在临床特征、骨髓/外周血细胞形态学、免疫表型、细胞遗传学、分子生物学及总生存期等各项指标的差异, 同时探讨影响 AML 预后的危险因素。用 Cox 多因素回归分析生存与预后指标。结果 M4和M5患者白细胞计数最高, M2患者最低(P=0.008), 而红细胞、血红蛋白和血小板计数差异无统计学意义(P均>0.05)。细胞形态学方面, 4组间骨髓和外周血原始细胞比例和杯口细胞阳性比例差异均有统计学意义(P均<0.05)。骨髓和外周血中原始细胞比例M1最高, M2最低(P均<0.001)。骨髓标本M1的杯口细胞阳性率...     

流式细胞术在非造血系统肿瘤骨髓侵犯检测中的价值

目的 探讨流式细胞术在识别CK阳性和阴性非造血系统肿瘤骨髓侵犯中的价值.方法 选取代表10种常见人类上皮来源肿瘤的26个细胞系和1种人淋巴瘤细胞系、1种T淋巴母细胞白血病细胞系,均购自美国标准生物品收藏中心.选择2009年7月至2010年6月北京市道培医院5份非造血系统肿瘤患者、15份血液系统肿瘤患者、15份移植后骨髓恢复正常的对照组患者骨髓标本.复苏冻存的各细胞系,传代培养至细胞进入对数生长期.破膜后使用胞浆CK-FITC抗体做荧光标记,进行四色流式细胞术检测,分析肿瘤细胞CK表达率.骨髓标本按照我室常规四色直接免疫荧光标记法做胞膜和胞浆染色,通过系别标志和幼稚细胞标志,以及CK表达情况,根据2008年世界卫生组织诊断标准做出相应诊断或者排除造血系统肿瘤.结果 所有上皮来源的肿瘤细胞系均不同程度表达CK,平均CK表达率为81.1%,而淋巴系统肿瘤细胞系均不表达CK.2例上皮来源肿瘤均表达CK,其中1例甲状腺癌病例CK表达率为100.0%,1例肺癌病例CK表达率为98.2%.血液系统肿瘤和对照组骨髓标本均不表达CK,分别表达相应的血液学标志:如CD45和系别标志,或者CD138和胞浆轻链.3份非上皮来源的非造血系统肿瘤骨髓标本均不表达CK.CK阳性或阴性的非造血系统肿瘤不表达造血细胞标志:如CD45、HLA-ABC、HLA-DR DP DQ,不表达特异性系别标志.而CK阳性可能有助于提示上皮来源肿瘤的诊断.结论 使用流式细胞术检测造血细胞标志和CK可以有效排除CD45阴性的造血系统肿瘤,检测CK阳性和阴性非造血系统肿瘤骨髓侵犯.

Abstract：

Objective To study the value of flow cytometry in identifying metastatic CK positive and negative nonhematopoietic neoplasms in bone marrow. Methods Twenty-six cell lines representing ten epithelial neoplasms, one lymphoma cell line and one human T cell lymphoblast-like cell line were purchased from American Tissue Culture Collection. From July 2009 to June 2010, five nonhematopoietic neoplasms,fifteen hematopoietic neoplasms and fifteen control patients with complete remession after hematopoietic stem cell transplantation were collected in Beijing Daopei Hospital. Cryopreserved cell lines were thawed and cultured until they entered log phase. After permeabilization, cell lines were analyzed by staining with cytoplasmic CK-FITC antibody using four-color flow cytometer. The percent CK positivity was measured by comparing with negative control. Bone marrow samples were stained with membrane and cytoplasmic antibodies according to our routine methods. Based on lineage markers and blast markers as well as CK expression, the relevant hematopoietic diseases were diagnosed or excluded according to 2008 World Health Organization diagnosis standards. Results All epithelial neoplasm cell lines expressed CK, with average positive percentage 81.1%. All the lymphoid tumor cell lines didn't express CK. Two epithelial neoplasms were CK positive, 100. 0% in thyroid carcinoma and 98. 2% in lung carcinoma, respectively. Hematopoietic tumor and control samples didn't express CK. They expressed relevant hematopoietic markers, such as CD45 as well as lineage markers, or CD138 and cytoplasmic immunoglobulin light chain. Three nonepithelial nonhematopoietic neoplasms didn't express CK. CK positive or negative nonhematopoietic neoplasms didn't express hematopoietic markers such as CD45, HLA-ABC and HLA-DR DP DQ, as well as lineage specific markers. Besides, CK positive might be helpful to suggest epithelial origin. Conclusion Flow cytometry with hematopoietic markers and CK can effectively exclude hematopoietic tumor and identify metastatic CK positive and negative nonhematopoietic neoplasms in bone marrow.     

外周血白细胞与骨髓有核细胞和巨核细胞形态学分类计数参考区间的建立

目的:建立外周血白细胞、骨髓有核细胞和巨核细胞形态学分类计数的参考区间。方法:选取2012年4月至2020年6月河北燕达陆道培医院参与筛查造血干细胞移植的健康供者4 221名,年龄36（3~72）岁,其中男2 520名,女1 701名。按照年龄分为4组：儿童组：≤14岁［334名,年龄11（3~14）岁］;青年组：>1...