骨髓增生异常综合征骨髓细胞淋巴系免疫标志及其增殖特性临床意义探讨

目的：探讨骨髓增生异常综合征(MDS)骨髓细胞淋巴系免疫标志及其增殖特性的变化和意义。方法：用流式细胞仪(FCM)分析了45例MDS患者和10例良性血液病患者(对照组)骨髓细胞淋巴系免疫标志及其增殖特性。结果：MDS组T细胞标志CD2、CD7。早期B细胞标志CD9。干／祖细胞标志HLA-DR阳性表达率明显高于对照组(P＜0.05)；RA和RAEB组分别与对照组比较，T系标志CD2、CD7，阳性表达率明显高于对照组(P＜0.05)，HLA-DR明显高于对照组(P＜0.01)，B系标志CD9、CD10、CD19，与对照组无差异(P＞0.05)。随病情进展CD2+表达率明显下降，HLA-DR~+表达率明显升高。在S+G2／M期申CD2+细胞所占比例RAEB较RA明显降低(P＜0.05)，CD7+细胞所占比例RAEB较RA明显升高。结论：MDS骨髓细胞T淋巴系免疫标志和增殖特性异常，表明T淋巴细胞增殖分化受阻，提示细胞免疫功能失调在MDS发病和病情进展中可能起作用。

STUDY ON CLINICAL SIGNIFICANCE OF BONE MARROW LYMPHOID IMMUNOPHENOTYPE AND PROLIFERATION ACTIVITY IN MYELODYSPLASTIC SYNDROME

Objective:To investigate the clinical value of lymphoid immunophenotype and proliferation activity on bone marrow in myelodysplastic syndrome(MDS).Methods:Bone marrow cells from 45 patients with newly diagnosed MDS and 10 cases of nonmalignant hematologic diseases (served as control)were evaluated by flow cytometric immunophenotyping(FCM IM) and FCM DNA/cell surface maker dual parameter analysis.The panel of monoclonal antibody(McAb) used in this study included CD 2?CD 7?CD 9?HLA DR?CD 10 ?CD 19 .Results:Compared to the control group, the positivity of T and B cell surface maker CD 2? CD 7? CD 9? HLA DR were remarkably increased in MDS patients ( P <0.01). RA and RAEB groups,the positivity of CD 2?CD 7 ( P <0.05)? HLA DR ( P <0.01) were significantly higher than control group,while CD 9?CD 10 ?CD 19 had no statistical difference ( P >0.05),and the proportion of the CD + 2 cell was significantly lower ( P <0.05)and CD + 7 cell was significantly higer ( P <0.05) in RAEB than in RA to the bone marrow at (S+G 2)/M stage.Conclusion:T lymphoid immunophenotype and proliferation activity on bone marrow in MDS were abnormal,which meant that T cells were arrested at the proliferation and differentiation stage.The cellular immune function abnormity may play an important role in MDS.