摘要目的 探讨骨髓切片幼稚前体细胞异常定位(ALIP)样结构与急性髓系白血病(AML)早期复发的相关性.方法 通过计算机影像处理技术检测幼稚前体细胞至骨内膜间距,光学显微镜显像下计算前体细胞成簇密度,回顾性分析了40例骨髓完全缓解的AML患者的临床资料.结果 除了单个或两个聚集前体细胞外,完全缓解期患者骨髓内还存在3～5个前体细胞的集落.成簇前体细胞而非单或两个前体细胞是提示复发的危险因素.以成簇密度＞4.0/mm2为临界值,提示早期复发的敏感度和特异度分别为51.5％和85.7％.结论 完全缓解期间骨髓的成簇ALIP样结构可能是早期复发的独立危险因素.当成簇密度＞4.0/mm2时提示预后较差,需要积极干预来预防血液学复发.

abstractsObjective To investigate the correlation between abnormal localization of immature precursors (ALIP)-like structure in bone marrow biopsy and early relapse of acute myeloid leukemia (AML).Methods Computer image processing technology was performed to detect of the distance between precursors and endosteum,and density of precursors was also calculated under light microscopic image.Clinical data of 40 AML patients with complete remission (CR) were analyzed.Results Beside single and double precursors,there were also clustered precursors of 3-5 cells during CR.Clustered precursors,but not single and double precursors,was a risk factor of relapse.Early relapse was detected with a sensitivity of 51.5 ％ and a specificity of 85.7 ％ using a standard cut-off value of ＞4.0/mm2 for cluster density.Conclusions Clustered precursors in bone marrow sections during CR may be an independent risk factor of early relapse.Cluster density ＞ 4.0/mm2 may indicate poor prognosis in AML patients and early aggressive interventions are needed to prevent hematologic relapse.