维吾尔族骨髓增生异常综合征患者淋巴细胞免疫表型检测的临床意义

Clinical significance of detecting lymphocytes immunological phenotype in Uyghur patients with myelodysplastic syndromes

目的分析维吾尔族骨髓增生异常综合征(MDS)患者淋巴细胞免疫表型特点及其在诊断、分型和预后中的临床意义。方法选择新疆喀什第一人民医院2013年3月到2016年3月41例MDS患者(MDS组)和30例非MDS患者(non-MDS组)为研究对象。运用多参数流式细胞术(CD45/SSC设门法)识别淋巴细胞群及进行免疫分型检测骨髓淋巴细胞群比例,观察不同分化抗原的表达水平。结果 (1)淋巴细胞群比例在MDS组较non-MDS组显著升高[(23.47±10.12)%vs(15.15±10.08)%,P<0.01];在MDS各亚型[难治性血细胞减少伴多系发育异常(RCMD)、难治性贫血伴原始细胞增多(RAEB)-Ⅰ、RAEB-Ⅱ]间差异无统计学意义(P>0.05)。(2)淋巴细胞群不同分化抗原表达,MDS组的CD25+CD8+、CD7及CD8表达水平均较non-MDS组显著升高(P均<0.01);CD5、CD19表达水平显著降低(P<0.05,P<0.01);CD25+CD4+、CD4、CD25及CD56表达水平两组差异无统计学意义(P均>0.05);CD5的表达水平在RCMD与RAEB-Ⅱ显著高于RAEB-Ⅰ(P<0.01);CD25的表达水平在RCMD高于RAEB-Ⅰ和RAEB-Ⅱ(P<0.05);其他MDS抗原的各亚型间差异无统计学意义(P均>0.05)。结论多参数FCM能检测到维吾尔族MDS患者淋巴细胞异常免疫表型特征,可给MDS患者的临床诊断、分型及预后评价提供更多有价值的客观信息。

Objective To analyze the feature of lymphocytes immunological phenotype of myelodysplastic syndrome（ MDS） in Uighur ethnic group and its clinical significance for diagnosis,classification and prognosis. Methods Flow cytometry（ FCM） based on multiple parameters,41 cases of MDS patients and 30 cases of MDS（ non-MDS） lymphocytes in patients with immune sign expression rate for testing. Results（ 1） The proportion of lymphocyte population in MDS group was significantly higher than that in non-MDS group[（ 23. 47 ± 10. 12） % vs（ 15. 15 ± 10. 08） %,P 0. 01],while there no significant difference among subsets [refractory thrombocytopenia with multiple lineage dysplasia（ RCMD）,refractory anemia with excess blasts（ RAEB）-Ⅰ,RAEB-Ⅱ]（ P 0. 05）.（ 2） Expressions of different differentiation antigens of lymphocyte population： compared with non-MDS group,expression levels of CD25＋CD8＋,CD7 and CD8 in MDS group increased significantly（ all P 0. 01）; expression levels of CD5 and CD19 in MDS group decreased significantly（ P 0. 05,P 0. 01）; there were no significant differences in expression levels of CD25＋CD4＋,CD4,CD25 and CD56 between two groups（ all P 0. 05）. The expression level of CD5 in RCMD and RAEB-Ⅱ was significantly higher than those in RAEB-Ⅰ（ P 0. 01）. The expression level of CD25 in RCMD was significantly higher than those in RAEB-Ⅰ and RAEB-Ⅱ（ P 0. 05）,and there were no significant differences among other subsets of MDS antigens（ all P 0. 05）. Conclusion Multiparameter FCM can detect the feature of abnormal immunological phenotype in Uyghur MDS patients and provide more valuable objective information for clinical diagnosis,classification and prognosis of MDS patients.