摘要
目的探讨骨髓增生异常综合征(MDS)患者外周血循环CD34+细胞计数在疾病分型及预后中的意义。方法流式细胞仪测定16例健康者、40例MDS患者外周血循环CD34+细胞占有核细胞的百分比(简称CD34+细胞百分比)和绝对细胞数。依据WHO MDS诊断标准、染色体核型以及国际预后积分系统(IPSS)将MDS患者分别划分为RA/RARS/RCMD组和RAEBⅠ/RAEBⅡ组,染色体良好组、中间组、不良组,中危Ⅰ组、中危Ⅱ组、高危组。结果 MDS患者外周血循环CD34+细胞百分比、绝对数分别为0.67%和17.24个/μl,健康者分别为0.03%和1.63个/μl,两者比较差异有统计学意义(P<0.01)。MDS患者中,RA/RARS/RCMD组CD34+细胞百分比及绝对数分别为0.05%和3.50个/μl,RAEBⅠ/RAEBⅡ组分别为3.09%和81.95个/μl(P<0.01);染色体良好组CD34+细胞百分比及绝对数分别为0.05%和3.50个/μl,中间组为1.29%和18.23个/μl,不良组为3.09%和133.10个/μl,随着不良核型的出现,CD34+细胞百分比及绝对数依次增高(P<0.05);中危Ⅰ组CD34+细胞百分比及绝对数分别为0.05%和3.50个/μl,中危Ⅱ组为1.57%和35.55个/μl,高危组为8.15%和192.05个/μl,随着IPSS分值的递增,CD34+细胞百分比及绝对数逐渐增高(P<0.01)。结论 MDS患者外周血循环CD34+细胞计数存在异常增高现象,其计数水平的检测有助于MDS的分型和预后判断。
Objective To explore the significance of the number of circulating CD34＋ cells in the peripheral blood from pa- tients with myelodysplastic syndromes（MDS） on disease subtype and prognosis. Methods The percentage and absolute count of cir- culating CD34 ＋ cells of the 16 healthy individuals and 40 patients with MDS were measured by flow cytometry. Forty patients with MDS were divided into RA/RARS/RCMD subgroup or RAEB I/RAEB Ⅱ subgroup; favorable chromosomal subgroup, intermediate chro- mosomal subgroup and poor chromosomal subgroup;intermediate-risk I subgroup, intermediate-risk Ⅱ subgroup and high-risk sub- group according to WHO classification, chromosomal abnormalities and international prognostic scoring system（IPSS）. Results The percentage and the absolute count of circulating CD34＋ cells in peripheral blood from patients with MDS were 0. 67% and 17.24 cells/ μl, while they were 0. 03% and 1.63cells/μl in normal control（ both P 〈 0. 01 ）. In MDS group： the percentage and the absolute count of CD34 ＋ cells in RA/RARS/RCMD subgroup were 0, 05% and 3.50 cells/μl ,which were lower than 3.09% and 81.95 cells/ μl in RAEB I/RAEB Ⅱ subgroup（both P 〈 0. 01 ）. The percentage and the absolute count of CD34＋ cells in favorable chromosomal subgroup were 0. 05% and 3.50 cells/μl, while they were 1.29% and 18.23 cells/μl in intermediate subgroup and 3.09% and 133. 10 cells/μl in poor chromosomal subgroup, respectively. With the emergence of chromosomal abnol abnalities, the percentage and absolute count were gradually increased （ P 〈 0. 05 ）. The percentage and the absolute count of CD34 ＋ cells in intermediate-risk I （0. 05% and 3.50 cells/μl） , intermediate-risk Ⅱ （ 1.57% and 35.55 cells/μl） and hizh-risk subgroup （ 8. 15 % and 192. 05 cells/μ1） were gradually increased with the progressive increase of IPSS score （ all P 〈 0. 01 ）. Conclusion Detection of the number of cir- culating CD34＋ cells in peripheral blood cells may be a useful tool for subtyping and predicting the prognosis of MDS.
出处
《临床肿瘤学杂志》
CAS
2012年第9期832-835,共4页
Chinese Clinical Oncology
