骨髓增生异常综合征免疫表型及淋巴样小巨核的研究

Sutdy on the Immunophenotype of Myeloid Cells in Myelodysplastic Syndromes and Lymphoid Micromegakaryocyt

目的探讨免疫细胞化学法在骨髓增生异常综合征(MDS)的诊断价值。方法应用一组单克隆抗体采用生物素-亲和素桥联碱性磷酸酶酶标法对14例MDS患者和7例正常人进行免疫表型检测。并且对免疫细胞化学法和骨髓普通瑞氏染色在淋巴样小巨核细胞检出率方面进行比较分析。结果免疫细胞化学法可提高淋巴样小巨核细胞检出率。MDS患者CD 41+淋巴样小巨核细胞表达异常增高,且随RA/RA S向RAEB/RAEB-t进展,表达增高。CD 34和CD 13在RAEB/RAEB-t阶段表达异常增高;CD 33表达较正常人异常增高。随着RA/RAS向RAEB/RAEB-t病情进展,CD 33、CD 13表达逐渐增加;CD 14、CD 41无表达异常。结论免疫细胞化学法具有操作简便快捷,可进行形态学识别等优点,可提高淋巴样小巨核细胞检出率。免疫表型检测可用于MDS的诊断。

Objective To explore the value of immunocytochemistry in diagnosis of myelodysplastic syndromes（MDS）. Methods A panel of monoclonal antibodies（CD41, CD34, CD33, CD13, CD14）was used to detect the immunnophenotype of 14 MDS patients and 7 controll. Lymphoid micromegakaryocyte detection rate was compared between immunocytochemistry and Wright＇ s staining. Results Immunocytochemistry can improve lymphoid mieromegakaryocyte detection rate. In MDS patients, CD41 ＋ lymphoid mieromegakaryocyte expression abnormally/nerease and with RA/RAS evolving to RAEB/RAEB - t significantly increase. CD34 and CD13 expression abnormality increase in RAEB/RAEB - t stage; CD33 expression abnormality increase compared with controll patients; CD33 and CD13 expression gradually increase along with RA/RAS evolving to RAEB/RAEB - t; CD14, CD14 expression was normal. Conclusion The performance of immunocytochemistry was easy and fast. Immunocytochemistry has the merit of morphology characteristic identification and retrospective analyses and improve lymphoid lymphoid micromegakaryocyte detection -rote. lmmunophenotype detect of myeloid cells might be useful for the diagnosis in MDS patients.