骨髓增生异常综合征患者Fas抗原的表达及临床意义

目的:探讨Fas(CD95)在骨髓增生异常综合征(MDS)发病机制中的作用及临床意义。方法:用酶联免疫夹心法检测25例MDS患者血浆可溶性Fas(sFas),用流式细胞术检测骨髓(BM)CD34+细胞、CD34-细胞、外周血单个核细胞(PBMNCs)Fas抗原的表达。结果:MDS难治性贫血伴有原始细胞增多(RAEB)/转变中的RAEB(RAEB-t)组患者骨髓CD34+细胞百分率显著高于对照组及难治性贫血(RA)组(均为P<0.01);RA组及RAEB/RAEB-t组骨髓CD34+细胞Fas表达显著高于对照组(分别为P<0.01,P<0.05),其中RA组高于RAEB/RAEB-t组,有统计学意义(P<0.05);RA组患者骨髓CD34-细胞Fas表达高于对照组及RAEB/RAEB-t组患者(均为P<0.05)。两患者组血浆sFas显著低于正常对照(均为P<0.01),sFas水平与患者血红蛋白(Hb)浓度呈正相关(r=0.67,P<0.01)。结论:MDS患者骨髓、外周血细胞Fas抗原广泛表达,Fas表达异常与MDS的发生、发展密切相关。

Study on the expression of Fas antigen and plasma Fas of patients with myelodysplastic syndrom

Objective:To investigate the role of Fas in the pathogenesis of myelodysplastic syn-drom(MDS)and its correlation with clinical status.Method:plasma level of sFas and the expression of Fas antigen on mononuclear cell(MNC)membrane in25MDS patients and10normal controls were assayed by ELISA and FACS respectively.Results:The percent age of CD34 + Fas + cells was increased significantly(P<0.01,P<0.05)in refractory anemia(RA),and in refractory anemia with excess blasts(RAEB)/RAEB in transformation(RAEB-t)patients than in normal controls.The percent age of CD34 + Fas + cells in RA patients was much higher than that in RAEB/RAEB-t patients(P<0.05),and the per-cent age of CD34 - Fas + cells was increased significantly(P<0.05)in RA patients than in both RAEB/RAEB-t patients and normal controls.The levels of sFas decreased significantly(P<0.01)in RA and RAEB/RAEB-t patients than in normal controls.The sFas level was positively correlated with Hb con-centration(r=0.67,P<0.01).Conclusion:Fas antigen was extensively expressed in MDS patients,and Fas aberration was involved in the pathogenesis of MDS.