骨髓增生异常综合征患者细胞免疫表型异常

Abnormality of Immunophenotyping in Patients with Myelodysplastic Syndrome

本研究探讨骨髓增生异常综合征(MDS)患者细胞免疫表型异常,确定其在MDS诊断中的价值。应用流式细胞术(FCM)检测136例血细胞减少伴骨髓病态造血患者的细胞免疫表型,采用流式细胞术积分系统(FCSS)对检测结果进行判断,确定阳性结果的敏感性与特异性,并与传统的诊断方法进行相关性检验。结果表明:136例患者中有111例临床确诊为MDS,非MDS患者25例。在111例MDS患者中FCSS判断为阳性结果的有85例,判断为中间结果的有18例,阴性结果8例;而在非MDS组,FCSS确定为阴性结果的有24例,判断为中间结果的有1例,无阳性结果病例。FCSS的诊断敏感性为76.6%,特异性为100%,与传统的诊断方法具有良好的相关性(R=0.613,p=0.000)。结论:MDS患者具有多项免疫表型异常,并可以累及多个细胞群体,其中主要免疫表型异常和累及2个以上细胞群体是MDS与非MDS的鉴别要点。

The study was aimed to investigate the abnormality of immunophenotypes in patients with myelodysplastic syndrome （ MDS ） and its role in the identification of MDS. The cell immunophenotypes of 136 patients with hypocytosis accompanied by abnormal hematopoiesis of bone marrow were detected by flow cytometry, the detected results were evaluated by flow cytometric scoring system （FCSS）, and the sensitivity and specificity of positive results were determined by FCSS also. The correlation of results detected by FCSS to traditional diagnosis method was analysed. The results indicated that 111 out of 136 cases were diagnosed as MDS, and 25 were diagnosed as non-MDS. Among 111 MDS cases, 85 cases were FCSS positive, 18 cases were FCSS intermediate and 8 cases were FCSS negative,whereas in 25 non-MDS cases 24 cases were FCSS negative, 1 case was FCSS intermediate and no case was FCSS positive. The sensitivity of FCSS in identification of MDS was 76.6%, and the specificity of FCSS was 100%. There was a good correlation of FCSS to traditional method （R = 0. 613,p = 0. 000）. It is concluded that the various abnormalities of immunophenotyping are found in patients with MDS, in which the main immunophenotype abnormality and the abnormality involving two cell lineages are key points to distinguish MDS from non-MDS.