血液病患者外周血未染色大细胞与血涂片镜检间关系的探讨

摘要

Objective To explore the relationship between large unstained cell(LUC)counting anaIysis and the blood smear cell morphology in patients with hematologic diseases.Methods Collection of 212 cases of peripheral blood in patients with hematologic diseases,and 190 cases of control group.Used the ADVIA2120 blood cell analyzer for the de-termination of LUC,and prepared of blood smear for microscopic examination.U test was used for evaluating the differ-ence between the patients with hematologic diseases and the control subjects;Kappa test was applied to determine the concordance between LUC and blood smear cell morphology.Results The positive rate of LUC of hematological disor-ders patients were higher than control subjects,and the LUC was higher than that of the latter (P <0.05).The positive rate of LUC in patients with myeloid leukemia and MDS was higher,respectively was 60.87%,69.64%;and the posi-tive rate of LUC in the anemia and other hematologic diseases were lower,respectively was 15.15%,16.67%.Com-pared to bone marrow smear cell morphology,the sensitivity and specificity were 78.9% and 84.4% respectively with the ROC AUC as 0.833.Kappa consistency test between The hematologic diseases group and control group was dis-played Moderate consistency(Kappa=0.567,P <0.05).Conclusion LUC Could be used for the differential diagnosis of hematological diseases.LUC was used for illness monitoring and curative effect.%目的：探讨血液病患者的外周血未染色大细胞（LUC）检测与外周血涂片镜检结果间的关系。方法收集212例已确诊为血液病的患者的外周血标本，以190例非血液病住院患者为对照组。使用 ADVIA2120血细胞分析仪测定 LUC，并制备血涂片进行显微镜检查。用 u 检验评价血液病患者与对照组的 LUC 差异；用 Kappa 系数评价LUC 与血涂片结果的一致性。结果病例组 LUC 阳性率高于对照组，且前者的 LUC 高于后者（P ＜0．05）。血液病患者中髓细胞白血病及骨髓增生异常综合征的 LUC 阳性率较高，分别为60．87％、69．64％；而在贫血及其他血液疾病中 LUC 阳性率较低，分别为15．15％、16．67％。与骨髓涂片检查相比较，其敏感性为78．9％，特异性为84．4％，受试者工作特征（ROC）曲线计算曲线下面积为0．833。病例组 LUC 与血涂片结果具有中等一致性（Kappa＝0．567，P＜0．05）。结论LUC 对血液系统疾病的鉴别诊断具有一定的提示作用，LUC 可以用于评价疾病的病情进展和治疗效果。