骨髓增生异常综合征患者临床特征分析

Analysis of Clinical Features of Patients with Myelodysplastic Syndrome

目的探讨细胞形态学检查、流式细胞术、细胞遗传学对MDS诊断分型的作用。方法以2016年WHO对MDS诊断分型标准为主要参考,回顾性分析安徽医科大学附属安徽省立医院2013年5月～2017年的12月收治住院的120例成人MDS患者的临床症状、血常规、骨髓细胞学、骨髓病理、免疫表型、细胞遗传学方面的特点。结果 120例MDS患者,根据2016年WHO分类,有2例(1.67%)患者符合MDS伴单系病态造血(MDS-SLD);有27例(22.50%)患者符合MDS伴多系病态造血(MDS-MLD),各有3例(2.50%)和4例(3.33%)患者符合MDS伴环状铁粒幼红细胞伴单系发育异常(MDS-RS-SLD)和MDS伴环状铁粒幼红细胞伴多系发育异常(MDS-RS-MLD),各有34例(28.33%)和43例(35.83%)是MDS-EB-1和MDS-EB-2;2例(1.67%)单纯5q-的MDS;有5例(4.17%)患者MDS未分类。结论骨髓细胞形态学和外周血指标仍是MDS诊断的金标准,临床症状、血常规、骨髓细胞学、骨髓病理、免疫表型、细胞遗传学的综合考虑更有利于MDS的分型诊断,并对治疗、预后判断有重要指导价值。

Objective To investigate the role of cell morphology,flow cytometry and cytogenetics in the diagnosis of MDS.MethodsThe 2016 WHO reference classification criteria for MDS was used as the main reference.Retrospective analysis of clinical symptoms,blood routine,bone marrow cytology,bone marrow pathology,immunophenotype,cytogenetics of 120 adult MDS patients admitted toAnhui Provincial Hospital of Anhui Medical University from May 2013 to December 2017 aspects of the characteristics.Results In120 patients with MDS,according to the 2016 WHO classification,2 patients （1.67% ）were eligible for MDS with monosomichematopoiesis （MDS-SLD）;27 patients （22.50%）were eligible for MDS with multiline morbid hematopoiesis （MDS-MLD）,3 patients（2.50%）and4 patients （3.33%）were eligible for MDS with annular iron granulocytes with monophyletic dysplasia （MDS-RS-SLD）andMDS with annular iron granulocytes Multiple line dysplasia（MDS-RS-MLD）,34 cases（28.33%）and 43 cases（35.83%）were MDS-EB-1and MDS -EB -2,respectively;2 cases （1.67% ）were simple 5q -MDS;5 patients （4.17% ）had unclassified MDS.Conclusion Themorphology of bone marrow cells and peripheral blood markers are still the gold standard for the diagnosis of MDS.The comprehensiveconsideration of clinical symptoms,blood routine,bone marrow cytology,bone marrow pathology,immunophenotype and cytogenetics ismore conducive to the diagnosis of MDS.It has important guiding value for treatment and prognosis.