Objective: To analyze coincidence rate of acute myeloid leukemia (AML) sub-typing between transmission electron microscopy (TEM) and clinical discharge diagnosis.
Methods: Reviewing sub-typing results of TEM, light microscopy, flow cytometric analyzing, molecular biological detection and karyotype in 793 AML cases, comparing their coincidence rates with discharge diagnosis to reveal advantages of AML sub-typing by TEM.
Results: General coincidence rates of TEM, light microscopy, flow cytometric analyzing, molecular biological detection and karyotype on AML sub-typing were 63%, 59%, 52%, 47%, 26% and 23% respectively, and clinical coincidence rates of TEM on M1, M2a, M4 and M5, M6, M7, t (8; 21) and t (15; 17) were 39%, 34%, 17%, 74%, 50%, 73%, 87% and 89% respectively.
Conclusion: TEM has a higher coincidence rate in general AML sub-typing, especially strong screenings on t (15; 17), t (8; 21), M7, M5 and M6, but lower coincidence rates on M1, M2a and M4 sub-typing than other methods.
目的 分析透射电子显微镜（电镜）对急性髓系白血病（AML）诊断分型的临床符合率。方法 回顾性分析793例AML患者经电镜、细胞形态学、细胞化学、流式细胞术、分子生物学和染色体核型等方法分型结果,比较电镜及其他检测方法对AML分型与临床诊断的符合率,分析电镜对AML分型的优势。结果 6种检测方法AML分型符合率由高到低依次为电镜检测（63%）、细胞化学分析（59%）、细胞形态学分析（52%）、流式细胞术分析（47%）、染色体核型分析（26%）和分子生物学检测（23%）。电镜检测对M1、M2a、M4、M5、M6、M7、t(8;21) 和t(15;17)亚型的符合率分别为39%、34%、17%、74%、50%、73%、87%和89%。结论 电镜对AML分型的临床符合率明显高于其他方法,其中对t(15;17)、t(8;21)、M7、M5和M6有很强诊断筛查作用,对M1、M2a和M4分型与临床诊断符合率较低。