骨髓增生异常综合征免疫异常的表型

本文探讨免疫异常表型对骨髓增生异常综合征 (MDS )分型诊断及鉴别诊断价值。选用多种单克隆抗体 ,用流式细胞测定分析仪 ,对 4 9例MDS、 5 0例良性血液病患者 (贫血、粒细胞减少症、血小板减少性紫癜、感染等 )的骨髓细胞免疫表型进行测定分析研究。结果MDS 89 3%以上有二系或三系免疫表型异常 ,其中CD7、CD19、CD13、CD14、CD33、CD34、HLA DR免疫标志变化最大 ,明显高于正常对照组 (P <0 0 1) ;髓系抗原表达明显增高 ,而且随MDS进展恶化 ,FAB亚型抗原表达出现规律性变化 ,RA→RAS→RAEB→向RAEB T转化 ,较早期髓系抗原表达 (如CD13、CD33)逐渐增加 ,而较晚期髓系抗原表达 (如CD15、CD14 )逐渐减少 ;同时伴淋系抗原表达逐渐减少 ;骨髓干细胞 /祖细胞表面抗原 (如CD34、HLA DR ) ,随着MDS恶化发展 ,有逐渐明显增加异常表现 ,而且CD34、HLA DR早期抗原表达增高者 ,常常预后较差 ,易于转化成白血病。结论MDS患者骨髓细胞免疫异常表型 ,有利于MDS诊断、分型诊断及鉴别诊断 ,并对治疗、预后判断有重要指导价值[1,2 ,5] 。

Abnormalities on the Immuno-phenotypes in Patients with Myelodysplastic Syndrome

The diagnostic and identification values of the immuno phenotypic analysis were undergone by use of multiple monoclonal antibodies and flow cytometry analysis in 50 patients with benign hematological disorders Results showed that more than 89 3% of patients with myelodysplastic syndrome(MDS) had abnormalities in 2 or 3 lineages of immuno phenotypes among which the immuno phenotypic abnormalities exited in CD7,CD19,CD13,CD14,CD33,CD34, HLA DR markers,and showed the greater changes than those of the controls. The expressions of myeloid series antigens elevated significantly,showing a RA→RAS→RAEB→RAEB T transformations There were a gradual increases in the expressions of CD13 and CD33 as well as a gradual decreases in the expressions of CD15 and CD14 High levels of CD34 and HLA DR might indicate poor prognosis These data indicate that the immuno phenotypic analysis in cases of MGS is of value in the diagnosis,differential diagnosis, prognosis, and treatment of this syndrome