多参数流式细胞术分析骨髓增生异常综合征患者原始细胞的免疫表型特点

Immunophenotypic Features of Blast Cells in Patients with Myelodysplastic Syndromes by Multi-Parametric Flow Cytometry

目的:探讨骨髓增生异常综合征(MDS)患者原始细胞免疫表型特点及其在诊断、分型及预后中的临床意义。方法:应用多参数流式细胞术,对41例MDS患者和24例非MDS患者原始细胞免疫标志的表达率进行检测。结果:MDS组与非MDS(non-MDS)组相比,CD34、CD123和CD133在原始细胞群表达显著增高(P<0.01),CD38、HLA-DR、CD13、CD33、CD7和CD117表达均无显著差异(P>0.05);CD34在难治性血细胞减少伴有多系发育异常(RCMD)、难治性贫血伴有原始细胞增多-Ⅰ(RAEB-Ⅰ)和难治性贫血伴有原始细胞增多-Ⅱ(RAEB-Ⅱ)亚型间表达逐渐升高,在RCMD与RAEB-Ⅰ、RCMD与RAEB-Ⅱ及RAEB-Ⅰ与RAEB-Ⅱ亚型间表达有显著差异(P<0.05),CD133、CD117、CD13和HLA-DR在RAEB-Ⅱ表达比RCMD显著增高(P<0.05);其余抗原亚型间比较均无显著差异(P>0.05)。结论:多参数FCM能够检测到MDS患者原始细胞异常免疫表型特点,为临床对MDS患者诊断、鉴别诊断及预后评价提供更多客观的信息。

Objective：To investigate the characteristics of immunophenotype of blast cells in patients with myelodysplastic syndrome（MDS） and its clinic implications.Methods：Multi-parametric flow cytometry was used to detect the expressions of antigens of blast cells in 41 patients with MDS.Results：The expressions of CD34,CD123 and CD133 on blast cells in MDS group were much higher than in non-MDS group（P0.01）,but the expressions of CD38,HLA-DR,CD13,CD33,CD7 and CD117 had no significant differences between the two groups.Between patients of refractory cytopenia with multilineage dysplasia（RCMD） and patients of refractory anemia with excess of blast（RAEB）-Ⅰ,between RCMD and RAEB-Ⅱ,or between RAEB-Ⅰ and RAEB-Ⅱ,the expressions of CD34 were different（all P0.05）,meanwhile,the expressions of CD133,CD117,CD13,and HLA-DR on blasts of RAEB-Ⅱ were significantly increased than those of RCMD respectively（all P0.05）.The expressions of the other antigens had no significantly differences among the subtypes of MDS（all P0.05）.Conclusion：Flow cytometry can reveal the characteristics of immunophenotypic abnormalities of blast cells in patients with MDS and provide more information for the diagnosis,differential diagnosis and prognosis.