骨髓增生异常综合征CD34^(+)髓系前体细胞免疫表型定量分析及与临床特征的相关性研究  

Quantitative Analysis on Immunophenotype of CD34^(+)Myeloid Precursor Cells in Myelodysplastic Syndrome and Its Correlation with Clinical Features

作　　者：陈曦[1] 任方刚[1] 张耀方[1] 许晶[1] 夏婷 常建梅[1] 陈秀花[1] 覃艳红[1] 王宏伟[1] 徐智芳[1] CHEN Xi;REN Fang-Gang;ZHANG Yao-Fang;XU Jing;XIA Ting;CHANG Jian-Mei;CHEN Xiu-Hua;TAN Yan-Hong;WANG Hong-Wei;XU Zhi-Fang(Department of Hematology,Second Hospital of Shanxi Medical University Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西医科大学第二医院血液科实验室,血液病分子诊疗山西省重点实验室,山西太原030001

出　　处：《中国实验血液学杂志》2021年第3期832-839,共8页Journal of Experimental Hematology

基　　金：山西省回国留学人员科研资助项目(HGKY2019100)。

摘　　要：目的:探讨骨髓增生异常综合征(MDS)患者CD34+髓系前体细胞免疫标志的定量表达情况及其与临床特征的相关性,了解CD7和CD117的定量表达对低危MDS患者预后的影响。方法:采用多参数流式细胞术(MFC)检测79例初诊MDS患者骨髓CD34+髓系前体细胞各抗原的比例及平均荧光强度(MFI),比较各免疫标志的表达水平与临床特征的相关性,探讨CD7和CD117的定量表达对低危MDS患者总体生存率的影响。结果:高危MDS患者骨髓原始细胞比例(P<0.01)、红细胞数(P<0.01)和血红蛋白水平(P<0.05)均明显高于低危MDS患者,而促红细胞生成素水平低于低危MDS患者(P<0.05)。高危MDS患者CD34+原始细胞比例(P<0.01)、CD34+髓系前体细胞表面CD117的比例(P<0.05)以及CD7的MFI(P<0.05)较低危MDS患者明显升高,而CD123的MFI较低危MDS患者明显降低(P<0.05)。高危MDS患者CD15/CD34(MFI)和CD19/CD34(MFI)与总T细胞比例呈正相关(r=0.458;r=0.505),CD19/CD34(%)和CD19/CD34(MFI)与白细胞水平呈负相关(r=-0.469;r=-0.503)。低危MDS患者CD34+(%)分别与骨髓红细胞比例、外周血血小板(PLT)水平以及中性粒细胞水平呈正相关(r=0.426;r=0.486;r=0.495),但与乳酸脱氢酶水平呈负相关(r=-0.421);CD10/CD34(%)、CD10/CD34(MFI)和CD117/CD34(MFI)与WT1表达量呈正相关(r=0.745;r=0.800;r=0.434),而CD11b/CD34(%)与WT1表达量呈负相关(r=-0.457);CD19/CD34(%)和CD71/CD34(MFI)与NK细胞比例呈负相关(r=-0.786;r=-0.514);CD10/CD34(%)与Th/Ts呈正相关(r=0.738),CD7/CD34(MFI)与Th细胞比例呈负相关(r=-0.513);HLADR/CD34(%)和HLADR/CD34(MFI)与PLT水平均呈负相关(r=-0.461;r=-0.445),但HLADR/CD34(MFI)与骨髓中性粒细胞碱性磷酸酶(NAP)分数呈正相关(r=0.552)。CD7和CD117的定量表达对低危MDS患者总体生存率无显著影响。结论:MDS患者不同风险组CD34+髓系前体细胞免疫表型的表达与临床特征相关,综合骨髓细胞形态学、临床及实验室特征、免疫表型等指标将会对MDS患者的�Objective:To investigate the quantitative expression of immunophenotype of CD34^(+)myeloid precursor cells in myelodysplastic syndrome(MDS)patients and its correlation with clinical characteristics,and understand the effect of quantitative expression of CD7 and CD117 on the prognosis of low-risk MDS patients.Methods:Multiparameter flow cytometry(FCM)was used to detect the proportion and mean fluorescence intensity(MFI)of each antigen of bone marrow CD34+myeloid precursor cells in 79 MDS patients.The correlation between the expression level of each immune marker and clinical characteristics was compared.The effects of quantitative expressions of CD7 and CD117 on the overall survival rate of low-risk patients were explored.Results:Bone marrow blast cell proportion(P<0.01),RBC level(P<0.01),and Hb level(P<0.05)of high-risk MDS patients were higher,while EPO level(P<0.05)was lower than those of low-risk patients.The proportion of CD34^(+)blast cells(P<0.01),the proportion of CD117(P<0.05)and the MFI of CD7(P<0.05)were higher in high-risk patients than those in low-risk patients,but the MFI of CD123 was lower(P<0.05).In high-risk MDS patients,CD15/CD34(MFI)and CD19/CD34(MFI)positively correlated with the proportion of total T cells(r=0.458;r=0.505),while CD19/CD34(%)and CD19/CD34(MFI)negatively correlated with WBC levels(r=-0.469;r=-0.503).In low-risk MDS patients,CD34+(%)positively correlated with bone marrow erythrocyte proportion,PLT level and neutrophil level(r=0.426;r=0.486;r=0.495),but negatively correlated with LDH level(r=-0.421);WT1 expression level was positively correlated with CD10/CD34(%),CD10/CD34(MFI)and CD117/CD34(MFI)(r=0.745;r=0.800;r=0.434),while negatively correlated with CDllb/CD34(%)(r=-0.457);CD19/CD34(%)and CD71/CD34(MFI)negatively correlated with NK cell proportion(r=-0.786;r=-0.514);CD10/CD34(%)positively correlated with Th/Ts,while CD7/CD34(MFI)negatively correlated with the proportion of Th cells(r=0.738;r=-0.513);HLADR/CD34(%)and HLADR/CD34(MFI)negatively correlated with PLT level(r=-0.461

关 键 词：骨髓增生异常综合征 CD34+髓系前体细胞 流式细胞术 免疫表型 

分 类 号：R551.3[医药卫生—血液循环系统疾病]