骨髓增生异常综合征外周血循环微巨核细胞糖蛋白Ⅱb/Ⅲa的表达及其临床意义

目的:探讨骨髓增生异常综合征(MDS)患者外周血循环中的微巨核细胞糖蛋白(gPⅡb/Ⅲa)的表达及其临床意义。方法:采用碱性磷酸酶-抗碱性磷酸酶(APAAP)免疫细胞化学染色技术,观察MDS患者外周血涂片内的微巨核细胞。结果:87例MDS患者中,65例(74.7%)的血循环中检出有少量gPⅡb/Ⅲa阳性的微巨核细胞,在常规染色的血涂片上该细胞的外形与小淋巴细胞类似,故难以或无法加以识别。结论:免疫细胞化学染色技术简单易行,采用该技术检测MDS患者外周血循环中微巨核细胞将有助于MDS的诊断。     

骨髓活检小巨核细胞酶标染色对骨髓增生异常综合征的诊断价值

目的利用骨髓活检切片进行小巨核细胞酶标染色以检测骨髓增生异常综合征（MDS）患者小巨核细胞的情况,从而判断骨髓活检小巨核细胞酶标染色对MDS的诊断价值。方法分别对我院52例初诊为MDS患者的骨髓涂片及骨髓活检切片进行巨核细胞特异性抗体（CD41a）标记碱性磷酸酶抗碱性磷酸酶（APAAP）方法染色并与骨髓涂片常规瑞特染色方法对比镜检小巨核细胞的情况。结果 52例MDS患者骨髓涂片瑞特染色法中有18例检出小巨核细胞,阳性率为34.6%,0例检出淋巴样小巨核细胞,阳性率为0;骨髓涂片联合APAAP法中有30例检出小巨核细胞,阳性率为57.7%,22例检出淋巴样小巨核细胞,阳性率为42.3%;骨髓活检切片联合APAAP法有48例检出小巨核细胞,阳性率为92.3%,47例检出淋巴样小巨核细胞,阳性率为90.4%。三种方法检出小巨核细胞阳性率相比差异有统计学意义（P〈0.05）。三种方法检出淋巴样小巨核细胞阳性率相比,差异有统计学意义（P〈0.05）。其中骨髓活检切片酶标染色法检出小巨核细胞阳性率和淋巴样小巨核细胞阳性率最高。结论利用骨髓活检切片进行小巨核细胞酶标染色能更准确检出小巨核细胞和淋巴样小巨核细胞,并能直观显示巨核病态造血分布情况,为MDS早期诊断提供可靠依据。     

Polycythemia vera: Electron microscopy of the bone marrow in 10 non-treated patients

Summary Electron microscopy (thin sections and freeze-fracture replicas) was performed on the bone marrow of ten patients with Polycythemia vera prior to any treatment. In addition to a hyperplasia of all three cell lineages and the sinuses, atypias were observed in the maturing erythroblasts. These aberrations of normal development consisted mainly of deep invaginations of the nuclear envelope in proerythroblasts and conspicuous nuclear clefts in erythro- and normoblasts. In comparison with similar changes in dyserythropoietic and aplastic anemia as well as leukemia these alterations are discussed in connection with disturbances of DNA synthesis. Further atypias involved megakaryopoiesis which displayed microforms probably as an evidence for maturation arrest. These ultrastructural abnormalities with their morphological features of a neoplastic proliferation of all three cell lineages in Polycythemia vera are in good agreement with the new concept of a transformation of a pluripotent stem cell with clonal character.Supported by the Deutsche Forschungsgemeinschaft (DFG Ge 121/19)