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目的:通过新型计算机网格计点法定量分析骨髓纤维化强度,并探讨其与成人急性淋巴细胞白血病(ALL)患者预后的相关性。方法:以抽吸-活检一步取材法采集33例初发成人ALL患者及31例正常者骨髓,塑料包埋后切片行Gomori染色,光学显微镜成像系统摄片;依据网型测微器原理建立计算机网格记点软件,比较其与传统骨髓纤维化人工半定量评价等级的异同,进一步对所有骨髓网硬蛋白强度(RFD)进行定量分析,研究其与ALL预后的相关性。结果:我们建立的新型计算机网格计点法对骨髓RFD的定量与人工半定量纤维化等级法具有相同趋势(r2=0.792,P<0.05),但更精确;初发ALL患者骨髓RFD较正常者明显增高[(5.78±0.56)%∶(1.26±0.09)%,P<0.05];Cox回归模型分析ALL患者初发骨髓RFD为其预后不良因素,当RFD>3.64%时相对危险度最高,且该组患者总生存期明显少于RFD≤3.64%患者(P<0.05)。结论:新型计算机网格计点法能够准确定量骨髓RFD;ALL初发患者异常增殖的纤维组织是其预后不良的潜在高危因素。
OBJECTIVE: To quantitatively analyze the intensity of myelofibrosis by a new computerized grid point method and to explore its correlation with the prognosis of adult patients with acute lymphoblastic leukemia (ALL). Methods: Thirty-three adult patients with primary ALL and 31 normal controls were collected by suction-biopsy. The bone marrow was collected from plastic-embedded sections and photographed by optical microscope. The computer was set up based on the principle of microdialysis Grid point software, compared with traditional myelofibrosis artificial semi-quantitative evaluation of the level of similarities and differences, and further all of the bone marrow network protein quantitative analysis of RFD (RFD) to study its association with the prognosis of ALL. RESULTS: The new computerized grid point method we established had the same trend of quantification of bone marrow RFD and artificial semi-quantitative fibrosis grade (r2 = 0.792, P <0.05), but was more accurate. The RFD of bone marrow in newly diagnosed ALL patients was higher than that of normal (5.78 ± 0.56)%: (1.26 ± 0.09)% respectively, P <0.05]. Cox regression analysis of the bone marrow in patients with ALL showed poor prognosis, with the highest relative risk when RFD> 3.64% The overall survival of patients in this group was significantly less than that in patients with RFD≤3.64% (P <0.05). Conclusion: The new computerized grid point method can accurately measure bone marrow RFD. The abnormally proliferated fibrous tissue in ALL patients is a potential risk factor for poor prognosis.