120例骨髓增生异常综合征的细胞形态学及免疫表型检测分析

Analysis of cell morphology and immunophenotype detection in 120 patients with myelodysplastic syndrome

关键词:  骨髓增生异常综合征  血细胞  骨髓涂片  免疫表型

Key words:  myelodysplastic syndromes  blood cell  bone marrow smears  immunophenotyping

摘要:

［目的］评价血液及骨髓细胞形态学及干/祖细胞和骨髓细胞表面抗原的检测在骨髓增生异常综合征（MDS）诊断及预后判断中的价值。［方法］对120例MDS患者和对照组20例（缺铁性贫血13例，血小板减少紫癜7例）患者的血液常规测定采用Sysmex-xe-2100血常规分析仪，血液及骨髓细胞涂片采用瑞-姬氏染色法，免疫表型测定采用“Becton Dickinson FACSCalib”流式细胞仪进行分析。［结果］MDS患者外周血以两系或者三系减少多见；骨髓增生程度以活跃和明显活跃为主；病态造血以红系和粒系为主，各占95.0%、61.7%；免疫学表型：干/祖细胞抗原（CD34、HLA-DR）及髓系早期抗原（CD33、CD13、CD117）表达明显增高，并随着病情的恶化逐渐增高，MDS-RA组、RCMD组及RAEB组与对照组比较差异均有显著性意义（P<0.05）；MDS-RAEB-Ⅱ组与RA组CD34的表达比较差异有显著性意义（P<0.05）；髓系晚期抗原（CD15）在MDS-RAEB-Ⅱ型中降低明显，与对照组比较差异有显著性意义（P<0.05）。［结论］MDS患者血液骨髓细胞形态学及免疫表型的联合检测，有利于MDS的早期诊断、治疗及预后判断。

Abstract:

［Objective］To evaluate morphology of the blood and bone marrow cells and surface antigen detection of stem/progenitor and bone marrow cells in the diagnosis and prognosis of patients with myelodysplastic syndrome (MDS).［Methods］The study included 120 MDS cases and 20 cases as control group,which included 13 iron-deficiency anemia cases and 7 thrombocytopenic purpura cases.Blood routine was determined by "Sysmex - xe - 2100" blood analyzer.Blood and bone marrow smears were dyed by "Wright-Giemsa" dyeing method.Immunophenotypes were analyzed by flow cytometric using BD FACSCalib.［Results］MDS patients' peripheral blood showed two-line or three-line reduce. Bone marrows' myeloproliferative degree was active and obvious active. Pathological hematopoietic was seen with erythroid and myeloid lines, respectively account for 61.7% and 95.0%. Stem/progenitor cells' expression of antigens (CD34, HLA-DR) and myeloid early antigens (CD33, CD13, CD117) were significantly higher, and gradually heightened with the aggravation of the illness. MDS-RA,RCMD and RAEB type all had significant difference from control group(P<0.05). The expression of CD34 in MDS-RAEB-Ⅱ type had presented difference with MDS-RA (P<0.05). Myeloid late antigen (CD15) decreased significantly in MDS-RAEB-Ⅱ type (P<0.05).［Conclusion］Blood and bone marrow cell morphology combined with immunophenotype detection in MDS patients is helpful for early diagnosis, treatment and prognosis judgment of MDS.