骨髓增生异常综合征亚型分型标准的商榷

DISCUSSINON ON SUBTYPING STANDARD OF MDS

就１９８９～１９９１年３１例诊断ＭＤＳ病例，按ＦＡＢ分型标准（即原粒Ⅰ型＋Ⅱ型）及改良标准（原始粒＋早幼粒）分别进行亚型分型研究。结果，按ＦＡＢ分型ＲＡ型２２例，ＲＡＥＢ型８例，ＲＡＥＢ－Ｔ１例。按改良标准分型，则ＲＡ６例，ＲＡＥＢ１７例，ＲＡＥＢ－Ｔ６例，白血病２例。即按ＦＡＢ分型，ＲＡ型比例高，占７１％。按改良标准则ＲＡ型仅占１９％，前者２９％符合ＲＡＥＢ、ＲＡＥＢ－Ｔ，而按改良标准则８１％符合ＲＡＥＢ、ＲＡＥＢ－Ｔ，甚至白血病的诊断，二者相差均非常显著，亚型分型直接影响治疗，因此作者主张以ＦＡＢ分型标准来进行亚型分型为宜。

31 cases of MDS hospitalized from 1989 to 1991 were. separately classified according to FABtyping(myeloblast Ⅰand Ⅱ)and improved typing(myeloblast and promyelocyte).With FABtyping,22 cases are A,8 RAEB,1 RAER-T;but 6 RA,17RAEB,6RAEB-T and 2leukemias by improved typing.The result showed that the RA case number(71%)of FABtyping is obviously higher than that(19%)of improved typing. RAEB,RAEB-T comprise 29%in the former,but RAEB,RAEB-T and leukemia comprise 81%in the latter.They havesignificant difference. Since subtyping directly affects treatment results,we considered that FABtyping is suitable.