骨髓增生异常综合征患者骨髓单个核细胞CD34、CD117的表达及其临床意义

 目的　探讨骨髓增生异常综合征（MDS）患者骨髓单个核细胞CD34、CD117的表达及临床意义。方法　采用直接免疫荧光标记法标记细胞表面分化抗原，流式细胞术测定，对37例MDS患者的骨髓单个核细胞CD34、CD117表达及临床意义进行分析。依据MDS的WHO分型方案、染色体核型以及国际预后积分系统（IPSS）将MDS患者划分为RA-RARS-RCMD 组、RAEBⅠ-RAEBⅡ组；染色体良好组、染色体不良组；中危Ⅰ组、中危Ⅱ组、高危组。结果　RA-RARS-RCMD组19例中11例CD34、CD117表达阳性，RAEBⅠ-RAEBⅡ组18例患者CD34、CD117表达均阳性；随着疾病恶性程度的增高，CD34、CD117表达明显升高；染色体良好组22例中14例患者CD34、CD117表达阳性，染色体不良组15例患者均表达CD34、CD117；随着异常克隆的出现，CD34、CD117表达升高；中危Ⅰ组17例中9例CD34、CD117表达阳性；中危Ⅱ组11例、高危组9例，所有患者CD34、CD117表达均阳性；随着预后积分的递增，CD34、CD117表达随之升高。结论　CD34、CD117检测有助于MDS 的分型、预后判断。

Expression and significance of CD34, CD117 on bone marrow mononuclear cells of patients with myelodysplastic syndrome

Objective To explore the expression and significance of CD34, CD117 on bone marrow mononuclear cells of myelodysplastic syndromes (MDS). Methods Direct immunofluorescence staining was used by means of flow cytometry. 37 patients with MDS were divided into RA/RARS/RCMD subgroup, RAEB Ⅰ/RAEB Ⅱ subgroup; favorable chromosomal subgroup, poor chromosomal subgroup; intermediate-risk Ⅰ subgroup, intermediate-risk Ⅱ subgroup, high-risk subgroup respectively according to WHO classification,cytogenetic abnormalities and international prognostic scoring system (IPSS). Results CD34 and CD117 were positive respectively in 11 of 19 patients with RMRARS/RCMD, all cases in RAEB Ⅰ/RAEB Ⅱ expressed CD34 and CD117; increased expression of CD34 and CD117 was MDS grade-related. Favorable chromosomal subgroup, 14 of 22 patients were positive for CD34, CD117, all cases in poor chromosomes expressed CD34 and CD117; there was a direct relationship between phenotytic density and poor cytogenetic risk factor. CD34 and CD117 expression was present respectively in intermediate-risk Ⅰ (9/17), intermediate-risk Ⅱ (11/11) and highrisk subgroup (9/9); the phenotypic intensity also was correlated with IPSS scores. Conclusion Detection of CD34, CD117 may be a useful tool for subtyping and predicting the prognosis of MDS.