骨髓增生异常综合征髓系细胞免疫表型及其临床意义的研究

Study on the immunophenotype of myeloid cells in myelodysplastic syndromes and its clinical implications

目的：探讨骨髓增生异常综合征（ＭＤＳ）髓系细胞免疫表型的变化及其临床意义。方法：应用一组单克隆抗体，采用免疫酶标法对５１例ＭＤＳ、２１例再生障碍性贫血（ＡＡ）、２１例阵发性睡眠性血红蛋白尿症（ＰＮＨ）、１０例急性髓系白血病（ＡＭＬ）患者及１５名正常人骨髓细胞膜表面抗原ＣＤ１３、ＣＤ１４、ＣＤ３３和ＣＤ１５进行检测，同时还检测ＭＤＳ患者的骨髓细胞形态、染色体核型及姊妹染色单体分染（ＳＣＤ），并按分型进行促分化、促造血和小剂量化疗。结果：ＭＤＳ骨髓单个核细胞较正常人表达ＣＤ１４（３７．９２％对１６．６７％）、ＣＤ１３、ＣＤ３３（２９．６３％，３１．８３％对１６．４１％，１５．１２％）明显增加，而ＣＤ１５（２６．１４％对４０．８３％）明显减少；ＭＤＳ骨髓单个核细胞ＣＤ１４、ＣＤ１３、ＣＤ３３抗原表达还明显高于ＡＡ（１１．６２％，１４．１９％，１２．０１％）和ＰＮＨ（１４．４６％，１４．１９％，１２．０１％），ＣＤ１３、ＣＤ３３低于ＡＭＬ（６１．２４％，５２．３１％）；低危组ＭＤＳ（ＲＡ／ＲＡＳ）较高危组ＭＤＳ（ＲＡＥＢ－ｔ）的ＣＤ１４（２７．０３％对５４．２７％）、ＣＤ１３（２４．５６％对３６．４１％）、ＣＤ３３?

Objective:To explore the immunophenotype of myeloid cells in myelodysplastic syndromes and its clinical implications.Methods:A panel of monoclonal antibodies was used to detect CD 13 ,CD 33 ,CD 15 and CD 14 on the membrane surfaces of myeloid cells in the bone marrow from 51 patients with myelodysplastic syndromes (MDS),21 with aplastic anemia (AA),21 with paroxysmal nocturnal hemoglobinuria (PNH),and 15 normal subjects,by immunoenzymatic assay.The morphology and chromosome karyotype of bone marrow cells of MDS patients were also examined.Results:CD 14 + cells, CD 13 + cells and CD 33 + cells in the bone marrow were more in MDS patients than in normal controls,AA patients and PNH patients.CD 15 + cells in the bone marrow were less in MDS patients than in normal controls.The percentages of CD 14 ,CD 13 and CD 33 positive cells in the bone marrow of MDS patients were related to the percentage of myeloblast, the chromosomal aberrations and the response to treatment.Conclusion:There was an immunophenotypic misexpression of myeloid cells in MDS patients.Immunophenotype analysis of myeloid cells might be useful for the diagnosis and directing treatment in MDS patients.