骨髓增生异常综合征患者骨髓细胞免疫表型特点分析  

Analysis of the immunophenotypic characteristics of bone marrow cells in patients with myelodysplastic syndromes

作　　者：陈永红[1] 孟凡凯[1] 曾雯[1] 秦爽[1] 高开波[2] 胡采红 毛汉文 孙汉英[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030 [2]湖北省宜昌市第一人民医院 [3]湖北省武汉市第五医院

出　　处：《内科急危重症杂志》2012年第6期337-339,共3页Journal of Critical Care In Internal Medicine

基　　金：教育部博士点基金项目(No:200804870008);湖北省卫生厅临床医学支助项目(No:JX4B04);武汉市卫生局临床医学科研项目(No:WX12A05)

摘　　要：目的:探讨流式细胞术(FCM)检测骨髓增生异常综合征(MDS)患者骨髓细胞免疫表型在MDS诊断及预后中的价值。方法:用FCM分析44例初诊MDS患者骨髓细胞免疫表型,分析MDS患者免疫表型的表达及分布情况;建立流式积分系统(FCSS)分析其与WHO分型及国际预后积分系统(IPSS)、WHO分型预后积分系统(WPSS)积分的相关性。结果:MDS患者骨髓细胞免疫表型存在多种异常:①骨髓原始细胞表达成熟抗原CD11b、CD15,及淋巴细胞相关抗原CD2、CD5、CD7、CD19或CD56,原始、幼稚细胞比例增高。②成熟粒细胞CD13/CD16、CD11b/CD16关系模式异常,表达CD56,中性粒细胞颗粒性减低。③单核细胞有CD56和CD34异常表达,单核细胞比例增高等。④红系Gly表达减弱,CD71表达减少,有核红细胞比例增高。⑤MDS患者骨髓细胞FCSS积分与WHO分型、IPSS积分、WPSS积分呈正相关。结论:MDS患者骨髓细胞存在多种免疫表型异常,FCM分析MDS患者骨髓细胞免疫表型异常可以为MDS的诊断和预后提供参考。Objective ： To detect the immunophenotypes of bone marrow cells in patients with myelodysplastic syndrome （MDS） by flow cytometry （FCM）, and to evaluate the diagnostic and prognostic value of the immunophenotypic study in MDS patients. Methods ： FCM was used to detect the bone marrow cells immunophenotypes in 44 newly diagnosed patients. The characteristics of expression and distribution of the immunophenotypes were analyzed. Flow cytometry scoring system （FCSS） was established, and the correlation with WHO classification and international prognostic scoring system（IPSS）, WHO prognostic scoring system （WPSS） were also explored. Results： Multiple bone marrow cells immunephenotype disorders were detected in MDS patients. （1）Primitive cells expressed mature antigen CD11 b and CD15, or lymphocyte associated antigen CD2, CD5, CD7, CD19 or CD56, and the proportion of primitive and immature cells increased. （2）In mature granulocytes, the expression pattern of CD13/CD16 and CDllb/CD16 were anomalous, and neutrophilic granules were decreased, and the CD56 was expressed. （3）Abnormal phenotypes of monocytes were lower than the granuloeytes, including the deviant expression of CD56 and CD34, increased proportion of monocytes. （4） Erythroid abnormal phenotypes were the decreased expression of Gly-A and CD71, the increased proportion of nucleated red blood cells. （5）In patients with MDS, bone marrow cells FCSS were positively correlated with WHO clas- sification, IPSS score and WPSS score. Conclusions： Multiple abnormal immunephenotypes exist in bone marrow cells in patients with MDS, and FCM can be Used to detect immunophenotypic disorders of bone marrow cells in order to provide a reference for the diagnosis and prognosis for MDS patients.

关 键 词：骨髓增生异常综合征 流式细胞术 骨髓细胞 免疫表型 

分 类 号：R551.3[医药卫生—血液循环系统疾病]