骨髓增生异常综合征巨噬细胞增生与造血细胞凋亡的相关性

目的 观察骨髓增生异常综合征(MDS)巨噬细胞增生状况与原位细胞凋亡的相关性并探讨其意义。方法 用碱性磷酸酶-抗碱性磷酸酶免疫酶标(APAAP)技术(CD68抗原标记)结合DNA末端原位标记(ISEL)分析30例MDS患者(其中低危组21例、高危组9例)骨髓塑料冷包埋切片中巨噬细胞数量和造血细胞原位凋亡状况,并分析二者间的相关性。缺铁性贫血(IDA)12例作对照。结果 (1)MDS患者骨髓切片中CD68阳性细胞数为(29.2±33.0)/mm~2,对照组为(21.2±16.7)/mm~2(P>0.05);(2)MDS病例凋亡细胞数平均为(71.5±70.9)/mm~2,对照组为(37.3±23.0)/mm~2(P<0.05);(3)MDS低危组CD68阳性细胞[(35.5±37.0)/mm~2]和凋亡细胞数[(90.7±74.6)/mm~2]均高于高危组[(14.6±11.7)/mm~2和(26.8±33.1)/mm~2](P分别<0.05和<0.01);(4)MDS病例CD68阳性细胞数与造血细胞凋亡显示显著正相关;r=0.83,P<0.001;(5)MDS病例骨髓切片中CD68阳性细胞与凋亡细胞不显示位置上的相关性;(6)MDS病例CD68阳性细胞本身存在过度凋亡。结论 MDS存在过度凋亡;MDS低危组凋亡高于高危组;MDS巨噬细胞与造血细胞凋亡具有相关性。

Relationship between macrophages and apoptosis in patients with myelodysplastic syndromes

OBJECTIVE: To observe the relationship between macrophage proliferation and cell apoptosis in patients with myelodysplastic syndromes (MDS). METHODS: A double labelling method of immunohistochemistry (alkaline phosphatase anti-alkaline phosphatase, APAAP) and ISEL (DNA in situ end labelling) was used to detect the positive CD68 expression (macrophages) and apoptosis on cold plastic embedded bone marrow biopsy sections in 30 MDS cases. 12 cases of iron deficient diseases (IDA) were used as the control. RESULTS: (1) The number of CD68 positive cells in MDS were higher than that in controls (29.2 +/- 33.0/mm(2) bone marrow tissue vs 21.2 +/- 16.7/mm(2)) (P > 0.05); (2) The number of apoptotic cells in MDS group was much higher than that in the controls (71.5 +/- 70.9/mm(2) vs 37.3 +/- 23.0/mm(2), P < 0.05); (3) The number of CD68 expression (35.5 +/- 37.0/mm(2)) and apoptosis (90.7 +/- 74.6/mm(2)) in less advanced MDS were much higher than that in advanced MDS group (14.6 +/- 11.7/mm(2) and 26.8 +/- 33.1/mm(2), P < 0.05 and < 0.01 respectively); (4) CD68 expression showed an obvious positive correlation to apoptosis in MDS cases (r = 0.83, P < 0.001); (5) CD68 positive cells did not show location correlation to apoptotic cells; (6) CD 68 positive cells in MDS showed simultaneous apoptosis. CONCLUSIONS: Over-apoptosis existed in MDS. Less advanced group has a higher ratio of apoptosis than in advanced group. The correlation between macrophages and apoptosis indicates the participation of TNFalpha in apoptosis-induction during MDS development.