正常核型和异常核型骨髓增生异常综合征的细胞形态学特点比较

A comparative study on morphological features between myelodysplastic syndrome with normal karyotype and abnormal karyotype

目的:比较正常核型和异常核型骨髓增生异常综合征(MDS)的细胞形态学的特点。方法:回顾分析82例MDS患者,通过对正常核型和异常核型MDS患者的细胞形态进行观察,分析二者形态学的差别。结果:核型异常组31例,占37.8%,核型正常组51例,占62.2%,2组外周血比较,核型异常组易出现原粒细胞、早幼红细胞、大红细胞,P<0.05;骨髓细胞形态比较,核型异常组三系病态造血比例高(>30%),P<0.05;原粒、淋巴样小巨核和畸形血小板比例高,P<0.05;核型异常组红系病态造血易见子母核、奇数核和多核,P<0.05;核型异常组有6例转为急性白血病。结论:异常核型MDS较正常核型组细胞病态造血发生率明显增高,原始细胞比例增高,转为白血病的比例高,预后差。

Objective：To evaluate morphological features of myelodysplastic syndrome（MDS） with normal karyotype or abnormal karyotype.Method：Eighty-two MDS patients were analyzed retrospectively.The morphological features of patients with normal karyotype were compared with those of patients with abnormal karyotype Result：Thirty-one cases（37.8%） were with abnormal karyotype and fifty-one cases（62.2%） were with normal karyotype.In abnormal karyotype group,myeloblast,macroerythrocyte and prorubricyte more easily presented in peripheral blood（P0.05）.Rates of three lineages dysplasia（30%）,myeloblasts,lymphoid micromegakaryocytes and abnormal platelets were higher in abnormal karyotype group than those in control group（P0.05）.Erythroid multi-nuclei,odd nucleus and mother-child nucleus were observed in abnormal karyotype group.Six patients in abnormal karyotype group transformed to acute myelogenous leukaemia（AML）.Conclusion：MDS with abnormal karyotype is with higher incidence of dysplasia,ratio of blast cells and risk of transformation to AML.