文章：

流式细胞术单核细胞分群在现实世界环境中诊断慢性粒单核细胞白血病的实用性

Usefulness of Flow Cytometry Monocyte Partitioning in the Diagnosis of Chronic Myelomonocytic Leukemia in a Real-World Setting

原文发布日期：5 April 2025

DOI: 10.3390/cancers17071229

类型: Article

开放获取: 是

英文摘要：

Background: Based on CD14/CD16 expression, monocytes can be divided into the following three functionally distinct subsets: classical (MO1, CD14++/CD16-), intermediate (MO2, CD14+/CD16+) and non-classical (MO3, CD14dim/CD16-). An expanded MO1 subset (cutoff, ≥94%) was found to be predictive of CMML. However, the utility of this test in routine practice has important limitations, with some reporting low sensitivity or a lack of correlation. Here, we sought to evaluate the practical usefulness of this test by using our routine antibody panel and a new gating strategy. Methods: Our study included 56 peripheral blood (PB) and 69 bone marrow (BM) samples. The PB cohort included 20 patients with CMML, 21 with no myeloid neoplasms (non-MN) and 15 with other myeloid neoplasms (non-CMML-MN). The BM cohort included 25 CMML, 16 non-MN and 28 non-CMML-MN cases. Taking advantage of an existing 8-color myelomonocytic tube routinely used in our lab, we conducted a retrospective monocyte subset analysis using a new sequential gating strategy. Results: The assay was able to distinguish CMML from non-CMML cases with high sensitivity (90.0%) and specificity (88.9%) in blood samples using a cutoff value of MO1 > 94%. For BM samples, a reduced MO3 < 1.24% was more closely associated with CMML with a sensitivity of 96.0% and a specificity of 79.5%. A side-by-side comparison of our assay with the original “monocyte assay” showed strong agreement. Conclusions: Our study demonstrates the utility of a practical and robust approach for monocyte subset analysis in the diagnosis of CMML.

摘要翻译： 

背景：根据CD14/CD16的表达，单核细胞可分为以下三个功能不同的亚群：经典亚群（MO1，CD14++/CD16-）、中间亚群（MO2，CD14+/CD16+）和非经典亚群（MO3，CD14dim/CD16-）。既往研究发现，MO1亚群比例增高（截断值≥94%）对慢性粒-单核细胞白血病（CMML）具有预测价值。然而，该检测在常规实践中的应用存在重要局限性，有报道称其敏感性较低或缺乏相关性。本研究旨在通过采用本实验室常规抗体组合及新的设门策略，评估该检测的实际应用价值。方法：本研究纳入56例外周血样本和69例骨髓样本。外周血队列包括20例CMML患者、21例非髓系肿瘤患者及15例其他髓系肿瘤（非CMML-MN）患者。骨髓队列包括25例CMML、16例非MN及28例非CMML-MN病例。利用本实验室常规使用的8色髓系-单核细胞检测方案，采用新的序列设门策略进行回顾性单核细胞亚群分析。结果：在外周血样本中，以MO1 > 94%为截断值，该检测能以高敏感性（90.0%）和高特异性（88.9%）区分CMML与非CMML病例。对于骨髓样本，MO3 < 1.24%与CMML的相关性更强，敏感性达96.0%，特异性为79.5%。将本检测方法与原始"单核细胞检测法"进行平行比较，结果显示两者具有高度一致性。结论：本研究证明，采用实用且稳健的单核细胞亚群分析方法对CMML诊断具有重要价值。

原文链接：

Usefulness of Flow Cytometry Monocyte Partitioning in the Diagnosis of Chronic Myelomonocytic Leukemia in a Real-World Setting