巨核细胞免疫组化染色在各类血液病中的应用

Application of Megakaryocyte Immunohistochemical Staining in Various Blood Diseases

目的 了解巨核细胞免疫组化染色碱性磷酸酶-抗碱性磷酸酶（APAAP）法在各类血液病鉴别诊断中的意义.方法 各类血液病患者均列为研究对象.用APAAP法染色患者骨髓涂片,显微镜下计数巨核细胞并进行分类.结果 多（双）核巨核、单圆核小巨核、多（双）圆核小巨核均可不同程度见于白血病[如急性髓系白血病（AML）,急、慢性淋巴细胞白血病（A/CLL）,慢性粒细胞白血病急变等],骨髓增生异常综合症（MDS）,特发性血小板减少性紫癜（ITP）,骨髓增殖性疾病MPD[包括原发性血小板增多症（ET）、骨髓纤维化（MF）、真性红细胞增多症（PV）],淋巴瘤,多发性骨髓瘤（MM）,各种原因引起的贫血等病人骨髓涂片中,再生障碍性贫血（AA）未见巨核细胞.淋巴样小巨核仅见于MDS.结论 用APAAP法检查各类血液病骨髓涂片中的巨核细胞,有助于各类血液病的鉴别诊断.

Objective To understand the megakaryocytes immunohistochemical staining of alkaline phosphatase-anti-alkaline phosphatase （APAAP） method in the differential diagnosis of various blood diseases significance. Methods The various types of blood ill patients who had as their research ob）ect. APAAP staining bone marrow of patients with smear, megakaryocytes counted under a microscope and classified. Results Multiple （double） nuclear giant nuclear,single round of nuclear small megakaryocytes,multlple （double） round of nuclear small megakaryocytes could be different levels found in leukemia （such as acute myeloid leukemia AML, acute and chronic lymphocytic leukemia A/CLL, chronic myeloid Leukemia, CML,etc. ）, myelodysplastic syndrome （MDS）,idiopathic thrombocytopenic purpura （ITP）, myeloproliferative disorders MPD （including,essential thrombocythemia ET,myelofibrosis MF,polycythemia vera PV）,lymphoma,multiple myeloma （MM）,a variety of causes bone marrow smears in patients with anemia,aplastic anemia （AA） no megakaryocytes. Lymphoid found only in small megakaryocyte MDS. Conclusion The APAAP method for detecting various types of blood diseases in the bone marrow megakaryocytes smear could help the differential diagnosis of various blood diseases.