真性红细胞增多症患者骨髓CD_(34)阳性细胞凋亡及增殖特征研究

Apoptosis and proliferation of CD_ (34)positive bone marrow cells in patients with polycythemia vera

目的 了解真性红细胞增多症 (PV)患者骨髓CD34 阳性细胞的凋亡、增殖情况。方法 应用双色流式细胞仪检测 2 0例PV患者及 10例原发性血小板增多症 (ET)患者和 12名正常人骨髓CD34 阳性细胞AnnexinⅤ以及细胞增殖相关抗原Ki6 7的表达情况并分析其与PV临床表现的相关性。结果 PVCD34 阳性细胞AnnexinⅤ表达率为 (15 .96± 1.4 5 ) % ,ET为 (15 .5 3± 1.76 ) % ,明显低于正常对照组的 (2 3.6 1± 3.89) % (P <0 .0 5 ) ;CD34 阳性细胞Ki6 7表达率PV为 (4 8.79± 11.6 8) % ,ET为 (4 9.6 0±9.98) % ,明显高于正常对照组的 (33.87± 6 .82 ) % (P <0 .0 1) ;凋亡增殖比PV为 0 .33± 0 .10 ,ET为 0 .32± 0 .0 2 ,明显低于正常对照组的 0 .72± 0 .11(P <0 .0 1) ;CD34 阳性细胞凋亡与血红蛋白、白细胞计数、内源性红系集落呈负相关 (分别r=- 0 .4 81,P =0 .0 37;r=- 0 .5 38,P =0 .0 2 6 ;r=- 0 .6 32 ,P =0 5 0 )。凋亡增殖比与血红蛋白、白细胞计数呈负相关 (分别r=- 0 .5 37,P =0 .0 18;r=- 0 .6 6 7,P =0 0 0 3)。结论 PV患者骨髓CD34 阳性细胞有低凋亡及高增殖特点 ,低凋亡与疾病严重度相关。

Objective To study the apoptosis and proliferation of CD 34 positive(CD 34+) bone marrow cells(BMC) in patients with polycythemia vera(PV). Methods The expression of Annexin V and Ki67 of the CD 34+ BMC in 20 PV patients and control cases [10 essential thrombocythemia(ET), 12 normal persons] were assessed by bicolor flow cytometry (FCM), and the correlation between apoptosis and clinical situation was analysed in PV patients. Results The Annexin V expressions of CD 34+BMC were (15.96±1.45)% in PV patients and (15.53±1.76)% in ET patients which were lower than that in normal subjects [(23.61±3.89)%,(P<0.05)]. The Ki67 expression of CD 34+ BMC was(48.79±11.68)% in PV patients and (49.60±9.98)% in ET patients, which were significantly higher than that in normal controls (33.87±6.82)%. The ratio of apoptosis/proliferation in PV patients was 0.33±0.10 and in ET patients 0.32±0.02 which were significantly lower than that in normal controls 0.72±0.11 (P<0.01). The apoptosis of CD 34+ BMC was negatively correlated with the hemoglobin(Hb) levels (r=-0.481,P=0.037), white blood cells (WBC) (r=-0.538,P=0.026) and the numbers of endogenous erythroid colony(EEC)(r=-0.632,P=0.50), and the ratio of apoptosis/proliferation was negatively correlated with the Hb(r=-0.537,P=0.018)and WBC(r=-0.667,P=0.003) in PV patients. Conclusion There were lower apoptosis and higher proliferation in CD 34+ BMC of PV patients. Lower apoptosis was correlated with the severity of the disease.