摘要
目的 探讨骨髓增生异常综合征（MDS）患者骨髓CD34＋细胞亚群及细胞周期分布异常的临床意义.方法 采用流式细胞术检测50例（17例低危、33例高危）MDS患者、8例MDS转化的急性髓系自血病（MDS-AML）及25例对照组原代骨髓CD34＋CD38＋、CD34＋CD38-细胞亚群及G0/G1期、S期和G2/M期细胞比例.结果 高危和MDS-AML组骨髓CD34＋细胞比例[（2.29±2.17）%、（18.69±17.47）%]明显高于对照组[（0.36±0.49）%,P＜0.05].低危、高危及MDS-AML组CD34＋CD38＋细胞相对比例[（86.09±7.79）%、（81.68±11.82）%、（82.88±2.60）%]显著低于对照组[（92.21±3.85）%,P＜0.05],而CD34＋CD38-细胞比例[（13.91±7.79）%、（18.32±11.82）%、（17.13±2.60）%]显著高于对照组[（7.79±3.85）%,P＜0.05].MDS组CD34＋CD38-细胞比例与国际预后积分系统（IPSS）（r=0.493,P=0.001）、WHO分型预后积分系统（WPSS）积分（r=0.586,P=0.000）均呈正相关.低危、高危及MDS-AML组骨髓单个核细胞（BMMNC）中G0/G1期细胞比例[（94.52±4.32）%,（96.07±3.88）%,（94.65±4.55）%]明显高于对照组[（88.94±7.30）%,P＜0.01],而3组S期[（4.63±3.34）%,（3.45±3.80）%,（5.12±4.55）%]和G2/M期[（0.84±1.52）%,（0.48±0.74）%,（0.22±0.34）%]细胞比例明显低于对照组[（9.06±6.50）%,（2.00±2.93）%,P值均＜0.05],3组S＋G2/M期细胞比例明显高于对照组（P＜0.01）.CD34＋CD38-细胞比例≤12.0%的MDS患者治疗有效率高于CD34＋CD38-细胞比例＞12.0%的患者,但差异无统计学意义.结论 MDS患者原代骨髓CD34＋细胞亚群分化异常,BMMNC存在G1期阻滞现象,提示CD34＋细胞亚群和细胞周期测定可能有助于MDS患者的辅助诊断以及疗效和预后判断.
Objectives To detect the abnormalities of CD34＋ cells differentiation and bone marrow cell cycle in myelodysplastic syndrome （MDS）. Methods Fifty newly diagnosed MDS （ 17 in low risk and 33 in high risk）, 8 acute myeloid leukemia preceded by MDS （MDS-AML） and 25 normal controls were enrolled into this study. Their CD34＋ CD38＋, CD34＋CD38- bone marrow cells and bone marrow cell cycle were measured with flow cytometry. Results The mean percentages of CD34＋ cells in bone marrow karyocyte of high risk [ （2.29 ±2.17）% ] and MDS-AML groups [ （ 18.69 ± 17.47）% ] were significantly higher than that of control group [ （ 0.36 ± 0.49 ）%, P 〈 0.05 ]. The mean percentages of CD34＋CD38＋ cells were significantly lower in low risk, high risk and MDS-AML groups [ （ 86.09 ± 7.79 ）%, （ 81.68 ± 11.82）% and （82.88 ±2.60）%, respectively] than that in control group [ （92.21 ±3.85）%, P〈0.05], thus the percentages of CD34＋CD38- cells were significantly higher in either MDS （low risk and high risk） or MDS-AML groups [ （13.91 ±7.79）%, （18.32 ±11.82）% or （17.13 ±2.60）%, respectively] than that in control group [ （7.79 ± 3.85 ）%, P 〈 0.05 ]. The percentages of CD＋34 CD-38 cells of MDS cases correlated directly with their International Prognostic Scoring System （IPSS） （r =0.493, P =0.001 ） and WHO Adapted Prognostic Scoring System （WPSS） （ r = 0.586, P = 0.000 ） scores. The percentages of bone marrow mononuclea cells （BMMNCs） in G0/G1 phase of in low risk, high risk and MDS-AML groups [ （94.52 ±4.32）%, （96.07 ± 3.88 ）% and （94.65 ± 4.55 ）%, respectively ] were significantly higher than that in control group[ （88.94 ±7.30）%, P 〈0.01 ], thus the percentages of BMMNCs in S and G2/M phase were significantly lower in either MDS （low risk and high risk） or MDS-AML groups than that in control group （P〈0.05）. MDS patients with low percentages of CD34＋CD38- cells presented higher therapeutic efficacy than
出处
《中华内科杂志》
CAS
CSCD
北大核心
2010年第11期963-966,共4页
Chinese Journal of Internal Medicine
基金
“十一五”国家科技支撑计划（2008BA161802）
天津市科技支撑计划,重大疾病防治专项基金（07ZCGYSF00600）
