检验医学 ›› 2026, Vol. 41 ›› Issue (10): 955-960.DOI: 10.3969/j.issn.1673-8640.2026.10.004

• 论著 • 上一篇    下一篇

外周血细胞形态学分级报告在血液肿瘤早期筛查中的应用价值

魏亚丽, 常楠, 白雪丽, 路其凤, 侯婷婷, 李钿, 李远, 沈亚娟()   

  1. 山东第一医科大学附属省立医院临床医学检验部, 山东 济南 250021
  • 收稿日期:2025-05-21 修回日期:2026-04-19 出版日期:2026-10-30 发布日期:2026-10-20
  • 通讯作者: 沈亚娟,E-mail:shenyajuanchina@126.com。
  • 作者简介:魏亚丽,女,1992年生,博士,主治医师,主要从事临床血液学人工智能研究。
  • 基金资助:
    山东省自然科学基金面上项目(ZR2021MH295);山东省立医院孵育基金项目(2023FY041)

Application value of peripheral blood cell morphology grading reports in the early screening of hematological malignancies

WEI Yali, CHANG Nan, BAI Xueli, LU Qifeng, HOU Tingting, LI Tian, LI Yuan, SHEN Yajuan()   

  1. Department of Clinical Laboratory, Shandong Provincial Hospital,Shandong First Medical University, Jinan 250021,Shandong, China
  • Received:2025-05-21 Revised:2026-04-19 Online:2026-10-30 Published:2026-10-20

摘要:

目的 分析外周血细胞形态学分级报告在血液肿瘤早期筛查中的临床可行性和临床价值。方法 收集2019年7月—2024年6月山东第一医科大学附属省立医院奥体院区就诊患者1 019 664份血常规检验数据,筛选血液肿瘤患者首次外周血细胞形态学分级报告。基于性别、年龄、就诊临床科室和最终临床诊断等数据对外周血细胞形态学分级报告病例进行特征分析。结果 共筛选出1 010份血液肿瘤患者的首次外周血细胞形态学分级报告。2019—2024年各年外周血细胞形态学分级报告占总血常规报告的0.8‰~1.1‰,并呈逐年上升趋势。1 010例血液肿瘤患者中,男542例、女468例,性别差异无统计学意义(P=0.48);年龄4~89岁,中位年龄59岁,年龄差异有统计学意义(P<0.05)。非血液科室各年外周血细胞形态学分级报告占总血常规报告的22.1%~30.9%。1 010份首诊外周血细胞形态学分级报告中,一个层次、两个层次、三个层次报告分别为108、145、757份,有694份经骨髓形态学-免疫学-细胞遗传学-分子生物学(MICM)验证诊断,有316份因无MICM结果无法给出最终临床诊断。有92份一个层次、80份两个层次、516份三个层次报告经骨髓MICM验证诊断,诊断一致性分别为92.4%、95.0%、 99.4%。结论 外周血细胞形态学分级报告在临床实践中切实可行,可有效减少血液肿瘤临床漏诊率,对血液肿瘤的早期筛查具有重要价值。

关键词: 外周血细胞形态学分级报告, 血液肿瘤, 早期筛查

Abstract:

Objective To analyze the clinical feasibility and value of peripheral blood cell morphology grading reports in the early screening of hematological malignancies. Methods Totally,1 019 664 sets of blood routine test data from patients who visited Shandong Provincial Hospital of Shandong First Medical University(Olympic District) from July 2019 to June 2024 were collected. The first peripheral blood cell morphology grading reports of patients with hematological malignancies were screened. The cases of peripheral blood cell morphology grading reports were analyzed according to gender,age,clinical department and final clinical diagnosis. Results A total of 1 010 sets of first peripheral blood cell morphology grading reports of patients with hematological malignancies were screened. The proportions of peripheral blood cell morphology grading reports in total blood routine reports from 2019 to 2024 were 0.8‰-1.1‰,and it showed an upward trend year by year. Among the 1 010 patients with hematological malignancies,there were 542 males and 468 females,and there was no statistical significance in gender(P=0.48). The age ranged from 4 to 89 years,with a median age of 59 years(P<0.05). The proportions of peripheral blood cell morphology grading reports in total blood routine reports in non-hematological departments were 22.1%-30.9%. In the 1 010 first peripheral blood cell morphology grading reports,the numbers of reports of one level,two levels and three levels were 108,145 and 757,respectively. Totally,694 reports were verified by bone marrow morphology-immunity-cytogenetics-molecular(MICM) for diagnosis,and 316 reports could not give the final clinical diagnosis due to the absence of MICM results. Among the reports of one level,two levels and three levels,92,80 and 516 reports were verified by bone marrow MICM for diagnosis,respectively. Conclusions Peripheral blood cell morphology grading reports are feasible and can effectively reduce the clinical missed diagnosis rate of hematological malignancies,and have value for the early screening of hematological malignancies.

Key words: Peripheral blood cell morphology grading report, Hematological malignancy, Early screening

中图分类号: