骨髓增生异常综合征 (3) 38例组织化学染色分析

38例的骨髓(BM)及外周血(PB)分别作了铁、过碘酸—雪夫氏(PAS)与过氧化酶(POX)染色。铁染色32例,3/4的病例铁粒幼细胞>60％,7例环状铁粒幼细胞>BM有核细胞15％,但外铁均正常。转急白与否和大量环状铁粒幼细胞的出现未见明显关系。PAS染色31例,28例(90％)幼红细胞呈阳性反应。各型MDS幼红细胞虽均有阳性反应,但RA阳性细胞百分数与积分低(<5％)。红系有巨变者,幼红细胞PAS阳性细胞百分数与积分较高,这一结果与Di—Guglielmo′s综合征表现相似,据此可与巨幼细胞性贫血鉴别。PB作POX染色15例,有半数以上病例的中性粒细胞部分缺乏POX活性。

MYELODYSPLASTIC SYNDROME: A HISTOCHEMICAL STUDY IN 38 CASES

The bone marrow(BM) and peripheral blood(PB) preparations were stained with periodic acid-Schiff(PAS), iron and peroxidase(POX) in 38 cases with MDS. The sideroblast count exceeded 60% in three-quarter of 32 patients in which staining for iron was performed. the ringed sideroblasts accounting for more than 15% of all nucleated cells in the BM were found in 7 patients. However, the hemosiderin was normal.There was no correlation between the number of the ringed sideroblast and the evolvement of acute leukemia in this series. PAS staining of the BM was performed in 31 patients. Although the erythroblasts were positive in all groups of MDS, but in group RA the percentage and score of positive cells were very much low(less than 5%). The PAS positivity was high in the megaloblastoid erythroblasts which was analogous to that seen in Digugliemo syndrome and may be differentiated from megaloblastic anemia. POX staining of the peripheral blood smear of 15 patients revealed partial myeloperoxidase deficiency in one half of the cases.