摘要
目的探讨骨髓增生异常综合征(MDS)亚型中难治性贫血伴原始细胞增多(RAEB)患者骨髓细胞免疫表型特点及其在诊断、鉴别诊断及预后中的临床意义。方法应用多参数流式细胞术,对35例RAEB患者和20例非MDS患者骨髓细胞表面抗原表达进行检测。结果RAEB组与非MDS组相比,原始细胞比例明显升高(P〈0.01),成熟粒细胞比例显著下降(P〈0.01),而淋巴、单核及有核红细胞比例无显著差异(P〉0.05);RAEB组CD34、CD7和CD56在原始细胞表达明显增高(P〈0.01);CD19在淋巴细胞亚群表达降低(P〈0.05),而CD,。表达升高(P〈0.05),CD,表达无差异;HLA—DR、CD56及CD15^+ CD11b^-在粒-单核细胞亚群表达明显升高(P〈0.01),而CD10、CD15^+ CD11b^-表达明显下降(P〈0.01),CD13和CD33表达无差异;RAEB组CD34及CD7高表达者的生存期短于低表达者。结论多参数流式细胞术可用于检测RAEB骨髓细胞异常免疫表型特点,为临床对三系减少或者贫血患者的诊断、鉴别诊断及预后评价提供新方法。
Objective To investigate the characteristics of immunophenotype of bone marrow cells from patients with Refractory Anemia with Excess Blasts (RAEB) and its clinic implication. Methods Multiparametric flow cytometry was used to detect the expression of lineage and maturation-associated antigens in 35 RAEB patients (20 male, 15 female, Median Age 66) and 20 non-MDS patients ( 11 male, 9 female, Median Age 32.5,9 AA,7 PNH,4 IDA). Results Compared with the non-MDS group, the proportion of blast cells was significantly increased in the MDS-RAEB group ( P 〈 0. 01 ) , the percentage of granulocyte was significantly reduced( P 〈 0.01 ), but the percentages of lymphocyte, monocyte and nucleated erythrocyte were no significant difference ( P 〉 0.05 ). The expressions of haemopoietic stem/progenitor cell surface marker CD34 and T lymphocyte surface marker CD7 and Natural Killer CeU Related Antigen CD56 on blast cells were much higher than non-MDS group(P 〈0.01 ). The expressions of CD19 on lymphocyte was decreased (P 〈 0.05), however the expression of CD56 was significantly increased (P 〈 0.05 ), there is no difference between the two groups of the expression of CD7 on lymphocyte. The expression levels of HLA-DR, CD56 and CD15^+ CD11b^- on myelomonocytic cells were significantly higher, while the expression of CD10 and CD15^+ CD11^+b were significantly decreased than the non-MDS group (P 〈 0.01 ). The expressions of CD13 and CD33 were no significant difference between the two groups. The survival time of patients with higher expression of CD34 and CD7 is shorter than lower patients. Conclusions FCM can reveal the characteristics of immunophenotypic abnormalities of patients with RAEB and provide a new method for the diagnosis,differential diagnosis and prognosis for patients with cytopenia or anemia.
出处
《临床内科杂志》
CAS
2010年第4期261-264,共4页
Journal of Clinical Internal Medicine
基金
国家支撑计划2008BAI61B02