骨髓增生异常综合征（MDS）免疫表型研究

Study of immuno-phenotype of myelodysplastic syndrome

关键词:  骨髓增生异常综合征  免疫表型  抗原表达

Key words:  myelodysplastic syndrome  immuno-phenotype  antigen express

摘要:

［目的］ 探讨免疫异常表型对骨髓增生异常综合征（MDS）分型诊断及鉴别诊断价值。［方法］ 选用多种单克隆抗体，用流式细胞测定分析仪，对79例MDS、70例良性血液病人（贫血、粒细胞减少症、血小板减少性紫癜、感染）的骨髓细胞免疫表型进行测定分析。［结果］ MDS 89.3%以上有二系或三系免疫表型异常，其中CD19、CD13、CD14、CD33、CD34、HLA-DR免疫标志变化最大，明显高于正常对照组（P<0.01）。髓系抗原表达明显增高，而且随MDS进展恶化。FAB亚型抗原表达出现规律性变化：RA→RAS→RAEB→向RAEB-T转化。较早期髓系抗原表达（如CD13、CD33）逐渐增加，而较晚期髓系抗原表达（如CD15）逐渐减少；同时伴淋系抗原表达逐渐减少；骨髓干细胞/祖细胞表面抗原（如CD34、HLA-DR），随着MDS恶化发展，有逐渐明显增加异常表现，而且CD34、HLA-DR早期抗原表达增高者，常常预后较差，易于转化成白血病。 ［结论］ MDS病人骨髓细胞免疫异常表型，有利于MDS诊断、分型诊断及鉴别诊断，并对治疗、预后判断有重要指导价值。

Abstract:

［Objective］ This work is to research the immuno-phenotype significance in the classification and differentiation of Myelodysplastic Syndrome (MDS). ［Methods］ The immuno-phenotype of bone marrow cells was detected in 79 patients with MDS and 70 patients with benign hematological disease. ［Results］ More than 89.3% MDS patients had abnormality in 2 or 3 lineages of immuno-phenotype, among which CD19, 13, 14, 33, 34, HLA-DR were changed most greatly (P<0.01). Myeloid series antigens were significantly increased. They showed the regular change with the progress of illness. From RA to RAS, f rom RAS to RAEB, from RAEB to RAEB-T . CD15 and lympho-linaege antigen decreased step by step. High level CD34, HLA-DR indicated poor prognosis and such MDS tended to convert into leukemia. ［Conclusion］ Abnormal immuno-phenotype is valuable for diagnosis of classification and differentiation of MDS. It is important to test abnormal immuno-phenotype to guide the treatment and predict prognosis of MDS.