骨髓增生异常综合征与非造血干细胞克隆性疾病患者外周血及骨髓涂片细胞形态差异性研究

目的 对骨髓增生异常综合征(MDS)与非造血干细胞克隆性疾病患者外周血及骨髓涂片的细胞形态差异进行研究.方法 选取MDS患者与非造血干细胞克隆性疾病患者共165例,其中85例MDS患者作为观察组,80例非造血干细胞克隆性疾病患者作为对照组.采集观察组与对照组患者中骨髓细胞及外周血进行涂片,并分析和判定异常细胞比例.结果 观察组患者的血涂片中巨核细胞、幼红细胞、幼粒细胞及原始粒细胞比例均高于对照组,差异有统计学意义(P﹤0.05);观察组患者的棒状小体(Auer小体)、假性Pelger-Huet样核异常细胞、异常胞质颗粒、原粒细胞、核出芽、核空泡、核浆发育不平衡及高分叶的比例均高于对照组,差异有统计学意义(P﹤0.01);观察组患者多圆核巨核细胞、单圆核巨核细胞、畸形血小板、淋巴样小巨核比例均低于对照组,差异有统计学意义(P﹤0.01).结论 MDS中诊断价值最重要的是细胞形态学的异常,但部分病例在早期需要结合其他检测技术提高诊断的准确率.

Morphology of the cells of peripheral blood and bone marrow smear in patients with MDS and clonal non-hematopoietic stem cells disorder

Objective To study the morphology of the cells of peripheral blood and bone marrow smear in patients with myelodysplastic syndrome (MDS) and clonal non-hematopoietic stem cell disorder. Method A total of 165 patients with MDS or clonal non-hematopoietic stem cell disorder were enrolled in the study, including 85 cases of MDS patients as study group, and 80 cases of clonal non-hematopoietic stem cells disorder as control group, from which the bone mar-row and peripheral blood smear were collected, and the proportion of abnormal cells were analyzed. Result In patients of study group, the proportion of megakaryocytes, erythroblasts, promyelocytic cells and myeloblasts were higher than those in the control group, and the difference was statistically significant (P<0.05); the proportion of Auer rod (Auer body), the nuclear abnormalities in pseudo Pelger-Huet anomaly, abnormal cytoplasmic granules, granuloblasts, nuclear budding, nuclear vacuoles, unbalanced growth of nucleoplasm and highly lobulated nucleus were higher in study group than control group, with significant difference observed (P<0.01);besides, the proportion of multinucleated megakaryo-cytes, mononucleated megakaryocytes, deformed platelets, and microlymphomegakaryocytes were lower in study group than those in the control group (P<0.01). Conclusion In MDS, the abnormality of cellular morphology is of essential di-agnostic value, but other detection techniques may be required in some cases in the early stage to improve the accuracy of diagnosis.