免疫表型对骨髓增生异常综合征早期诊断应用研究
Study on immuno-phenotype in early diagnosis of myelodysplastic syndrome
陈艳君 1王永才 1张蕾 1孙洪军 1安月 1许方1
作者信息
- 1. 大连医科大学附属第二医院 116023
- 折叠
摘要
目的 探讨免疫异常表型对骨髓增生异常综合征(MDS)早期诊断价值.方法 选用多种单克隆抗体,用流式细胞测定分析仪,对98例MDS、100例良性血液患者(贫血、粒细胞减少症、血小板减少性紫癜、感染等)的骨髓细胞免疫表型进行测定分析研究.结果 MDS89.3％以上有二系或三系免疫表型异常,其中CD7、CD19、CD13、CD14、CD33、CD34、HLA-DR免疫标志改变明显,明显高于正常对照组(P＜0.01)；髓系抗原表达明显增高,而且随MDS进展恶化,FAB亚型抗原表达出现规律性变化,RA→RAS→RAEB→向RAEB-T转化,较早期髓系抗原表达(如CD13、CD33)逐渐增加,而较晚期髓系抗原表达(如CD15、CD24)逐渐减少；同时伴淋系抗原表达逐渐减少；骨髓干细胞/祖细胞表面抗原(如CD34、HLA-DR).随着MDS恶化发展,有逐渐明显增加异常表现,而且CD34、HLA-DR早期抗原表达增高者,常常预后较差,易于转化成白血病.结论 MDS患者骨髓细胞免疫异常表型,有利于MDS早期诊断及鉴别诊断,并对治疗、预后判断有重要指导价值.
Abstract
Objective To research the immuno-phenotype's significance in the classification and differentiation of myelodysplastic syndrome( MDS). Methods The immuno-phenotype of bone marrow cells was detected in 98 patients with MDS and 100 patients with benign hematological disease. Results More than 89. 2% MDS patients had anor-mality in 2 or 3 lineages of immuno-phenotype,among which CD7,19,13,14,33, 34.HLA-DR changed most greatly,higher than normal(P<0. 01). Myeloid series antigens were significantly increased. They showed the relular change with the progress of illness. RA-RAS increased,CD1S ,24 and lympho-linaege antigen decreased step by step. High level CD34, HLA-DR indicated poor prognosis and such MDS tend to transfer into leukemia. Conclusion Anormal immnophetotype of MDS is valuable for diagnosis.
关键词
骨髓增生异常综合征/诊断/免疫学Key words
Myelodysplastic Syndromes/diagnosis/immunology引用本文复制引用
出版年
2012
NETL
NSTL
维普
万方数据