摘要
目的 :分析慢性粒-单核细胞白血病(chronic myelomonocytic leukemia,CMML)的细胞形态学特点,为对照,探索免疫标记物在CMML诊断中的意义及临床应用价值。方法:采用骨髓活检病理组织学方法分析39例CMML的病理学特点;采用免疫组化法,以CMML为实验组,慢性粒细胞白血病(chronic myelocytic leukemia,CML)及急性单核细胞白血病(acute monocytic leukemia,AMo L)为对照组,检测CD15、MPO、CD34、CD14、CD56、CD68(PG-M1)、CD163在上述3组中的表达。结果 :CMML骨髓病理组织学提示33例(84.6%)骨髓增生极度活跃,粒系细胞增生明显且形态异常,29例(74.4%)单核细胞增多,20例(51.3%)巨核细胞形态异常。粒细胞标记物CD15、MPO在CMML中的阳性表达率分别为(21.69±7.06)%,(33.96±5.94)%,其与CML及AMo L均有统计学差异。单核细胞标记物CD14、CD56、CD68(PG-M1)及CD163的阳性表达率分别为(10.10±2.51)%、(8.69±2.66)%、(13.35±4.32)%、(11.43±4.15)%,除CD56外,其余在CMML与AMo L的阳性率均有明显差异。原始细胞标记物CD34的阳性表达率为4.31±1.98%,与CML有统计学差异。结论:骨髓病理组织学及免疫组化有助于CMML的诊断及鉴别诊断。
Objective：To analysis the cell morphological characteristics in chronic myelomonocytic leukemia（CMML）,and investigate the expression of immune marker in the diagnose and clinical application value of CMML. Methods：Using the bone marrow biospy pathology to analysis the pathology characteristics in 39 cases of CMML. By using the immunohistochemistry to detect the expression of antibodies which included CD15,MPO,CD34,CD14,CD56,CD68（PG-M1）and CD163 in CMML,comparison with chronic myelocytic leukemia（CML） and the acute monocytic leukemia（AMo L） patients. Results：Hypercellularity was the markedly feature of the bone marrow histology in 33 cases（84.6%）of CMML. Increased granulocytic proliferation and obviously morphological abnormalities were observed in these cases. Monocytic cells were increased in 29 cases（74.4%）and 20 cases（51.3%）presented megakaryocytic morphological abnormalities. The marker in the granulocytic lineage expresses CD15 and MPO,which had respectively positive percentage of 21.69 ± 7.06% and 33.96 ± 5.94%,there were significantly statistical differences compared with CML and AMo L. The marker in the monocytes expresses CD14、CD56、CD68（PG-M1）and CD163,which were positive（10.10 ± 2.51）%、（8.69± 2.66）%、（13.35 ± 4.32）%、（11.43 ± 4.15）%,respectively. Except from CD56 positive CMML and AMo L,the rest had significantly statistical differences. The original marker which was positive expressed in CMML such as CD34 had the percentage of（4.31 ± 1.98）%,which had significantly statistical differences with CML. Conclusion：Morphological and immunohistochemical features of bone marrow biopsy are helpful in the diagnosis and differentiation.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2015年第12期1735-1738,共4页
Journal of Nanjing Medical University(Natural Sciences)
基金
江苏省卫生厅指导性科研项目(Z201402)
国家自然科学基金青年基金(81400079)
关键词
慢性粒-单核细胞白血病
骨髓活检
免疫组化
chronic myelomonocytic leukemia
bone marrow biopsy
immunohistochemistry
