流式细胞术对骨髓增生异常综合征和再生障碍性贫血患者骨髓细胞免疫表型的分析

Analysis on the immunophenotypes of myelodyplastic syndrome and aplastic anemia

检测骨髓增生异常综合征(MDS)和再生障碍性贫血(AA)患者骨髓细胞免疫表型特征,探讨其对二者发病机制、分型诊断及鉴别诊断的临床意义。选用多种单克隆抗体,应用直接免疫荧光法采用流式细胞术CD45/SSC设门,对23例MDS、14例AA、9例正常对照的骨髓细胞各免疫标志的表达率进行检测。结果:MDS组与正常对照组相比其造血干/祖细胞抗原CD34、HLA-DR、髓系早期抗原CD13、CD33、单核系抗原CD14、T淋巴细胞抗原CD7的表达率增高,髓系成熟抗原CD15、B淋巴系抗原CD19、CD20的表达率降低,DI值增高;由RA进展至RAEB,CD34、HLA-DR、CD13、CD33、CD14、CD7的表达率逐渐增高,CD15、CD3、CD19、CD20的表达率逐渐减低,DI值逐渐增高。AA组与正常对照组相比其CD34、CD13、CD33、CD15的表达率降低,CD3、CD7、CD25、CD22的表达率增高。MDS组与AA组相比其CD34、HLA-DR、CD13、CD33、CD14的表达率增高,CD3、CD5、CD7、CD15、CD19、CD20、CD22、CD25的表达率显著降低。MDS和AA患者骨髓细胞免疫表型分析,有助于揭示二者的发病机制,为临床提供新的诊断、分型及鉴别诊断方法。

The phenotypic features in cell-mediated immunity of patients with myelobysplastic syndrome(MDS) and aplstic anemia(AA) were analyzed in the present study in order to investigate the clinical usages of immunophenotyping in the pathogenesis,diagnosis and differential diagnosis of MDS and AA.A panel of monoclonal antibodies and the flow cytometry using CD45/SCC gating strategies were employed for the immunophenotyping on the bone marrow nucleated cells from 23 patients with MDS,14 patients with AA and 9 healthy individuals as controls.Compared with the controls,the rates of expressions of surface marker CD34 on haematopoitic stem/progenitor cells,HLA-DR,early antigens of myeloid system CD13 and CD33,surface marker CD14 of monocyte system and the CD7 antigen on T lymphocytes in MDS patients were significantly increased,however,those of mature antigen CD15 of myeloid system,surface antigen CD19 and CD20 on B lymphocytes in MDS patients were comparatively decreased with an increased DI value.In case of the AA patients,the expressions of CD34,CD13,CD33 and CD15 were decreased in comparison with those of the controls,but those of CD3,CD7,CD25 and CD22 were increased.In comparison of the expression of the surface molecules on various cells between MDS and AA,it was found that the expressions of CD34,HLA-DR,CD13,CD33 and CD14 were increased,while those of CD3,CD5,CD7,CD15,CD19,CD20,CD22 and CD25 were significantly decreased.From these observations,it is evident that the analysis of the immunophenotypes in patients with MDS and AA may be helpful for classification,diagnosis and differential diagnosis of these patients.