87例骨髓增生异常综合征多参数流式细胞术免疫表型分析

目的：了解骨髓增生异常综合征（MDS）的免疫表型特征。方法：利用CD45／SSC参数散点图设门方法，对87例MDS患者的骨髓幼稚细胞群、成熟粒细胞群和成熟单核细胞群细胞表面分化抗原进行分析。结果：MDS的异常免疫表型可以分为抗原跨系列表达、抗原跨阶段表达、成熟粒细胞抗原分化异常、抗原表达缺失或表达增强、成熟粒细胞或幼稚细胞群CD45／SSC表达异常。78例（90．0％）MDS患者可以检测到明确的异常抗原表达，74例（85．1％）存在≥2个免疫表型异常，异常免疫表型不仅存在于幼稚细胞群（70．0％），也存在于成熟粒细胞群（81．6％）和单核细胞群（39．1％）．常见的异常免疫表型包括：成熟粒细胞群CD13／CD16分化异常（41．3％）；幼稚细胞群CD45表达异常（34．5％）；成熟粒细胞群跨系列表达CD38（29．9％）；幼稚细胞群CD34＋CD11b＋跨阶段表达异常（24．1％）；成熟粒细胞群SSC减低（11．5％）；成熟粒细胞群跨系列表达CD56（8％）；单核细胞群跨系列表达CD56（8％）。随着患者骨髓幼稚细胞比例增高，异常免疫表型数量也逐渐增多。结论：在大多数MDS患者骨髓细胞中可以检测到明确的异常免疫表型，在此基础上应用多参数流式细胞仪可以有助于MDS的诊断和预后判断。

Analysis of Immunophenotype by Multi-color Flow Cytometry in 87 Cases With Myelodysplastic Syndrome

Objective： To understand the characteristics of immunophenotype by multi-color cytometry in patients with myelodysplastic syndrome （MDS）. Methods： FCM with four color and CD45/SSC gating were used to detect the antigen expression of myeloblast, granulocytes and monocytes in samples of bone marrow from 87 patients with MDS. Results： The abnormal phenotypes of MDS could be divided into five groups as asynchronous antigen expression, cross-lineage antigen expression, antigen over expression or antigen lack expression, abnormal pattern of antigen on granulocytes, and abnormal CD45/SSC expression on granulocytes or myeloblasts. The results showed that 78 patients（90. 0%） had abnormal phenotypes, 74 patients （85. 1%） had ≥2 abnormal phenotypes, abnomlal immunophenolype not only exist in blasts （70. 0%）, but also in granulocytes （81.6%） and monocytes（39. 1%）. The abnormal immunophenotypes included abnormal pattern CD13/CD16 （41.3 % ）, abnormal expression of CD45 on blasts （34. 5%）, abnormal expression of CD38 on granttbcytes （29. 9% ）, abnormal expression of CD11b on blasts （24. 1 %） ,abnormal expression of CD56 on granulocytes and monocytes （8% and 8%）. The number of abnormal phenotypes were more in HIGH RISK MDS than those in LOW RISK MDS. Conclusions： The abnormal immunophenotypes can be detected in the majority of patients with MDS and FCM may help identify MDS.