摘要
目的探讨骨髓增生异常综合征(MDS)患者采用流式细胞术检测骨髓细胞免疫表型对于临床诊断及治疗的应用价值。方法随机选取2011~2015年间160例患者骨髓标本,按是否为MDS分为MDS组及非MDS组,每组80例。MDS组:难治性贫血伴原始细胞增多Ⅰ(RAEB-Ⅰ)35例,RAEB-Ⅱ28例,难治性血细胞减少伴多系发育异常(RCMD)17例。比较不同细胞系群在各组中所占比率,并对两组患者及MDS组不同分型下流式积分值进行比较,采用Spearman相关性分析法分析流式积分与MDS分型及国际预后积分系统(IPSS)预后相关性。结果 MDS组的原始细胞群(7.58±3.9)%、单核细胞群(7.21±4.18)%、有核红细胞群(10.38±6.77)%及淋巴细胞群(23.33±10.19)%比率均较非MDS组患者有明显升高(P<0.05),而成熟粒细胞群(41.43±14.33)%比率有所下降(P<0.05);此外,以上五个细胞群中仅原始细胞群在MDS亚型(RCMD、RAEB-Ⅰ、RAEB-Ⅱ)中差异有显著性(P<0.01);MDS组及非MDS组流式积分值分别为(31.98±5.32)、(17.94±6.02)差异有显著性(P<0.01);同样在MDS三个亚型中,流式积分值差异依然存在,经Spearman相关性分析,随着疾病严重程度增加,流式积分值明显升高(r=0.652,P<0.01),且流式积分值与现有的IPSS相关性较好(r=0.778,P<0.01)。结论 MDS患者多存在多细胞群比例失调及多抗原表达异常情况,而通过流式积分对患者骨髓细胞免疫表型异常进行分析,即可为早期诊断、治疗及预后结果判断上提供可靠的客观数据。
Objective To research on the value of diagnosis and prognosis on MDS patients with abnormal immune phenotype detected by flow cytometry.Methods Bone marrow samples of 160 patients were selected and divided into MDS group and non- MDS group,80 cases in each group.MDS group：RAEB- Ⅰ 35 cases;RAEB- Ⅱ 28 cases;RCMD 17 cases.Compare different cell lines population proportion in each group and different type downflow integral value.Flow integration with MDS IPSS classification and prognostic were analyzed by Spearman correlation analysis.Results The original cell population（7.58 ±3.9）%,monocytes group（7.21 ±4.18）%,nucleated red blood cell group（10.38 ±6.77）%and lymphocyte populations（23.33 ± 10.19）%in MDS group proportion were significant higher than that of non- MDS group（P〈 0.05）,while the mature granulocytes group（41.43 ± 14.33）%proportion has declined,there were differences between the two groups（P 〈0.05）.In addition,only the original cell populations were significantly different（P〈 0.01） in MDS subtypes（RCMD,RAEB-Ⅰ,RAEB-Ⅱ）.Flow integral values of MDS and non- MDS group were（31.98 ± 5.32）,（17.94 ± 6.02） with significant difference（P〈 0.01）.Similarly,in the three subtypes of MDS,the flow integral value differences still exist,the spearman correlation analysis showed that along with the increase of the severity of the disease,the flow integral value significantly increased（r = 0.652,P 〈0.01）,and the integral value of the current flow and the IPSS had good correlation（r = 0.778,P〈 0.01）.Conclusion There are dysbacteriosis and multiple antigen expression abnormal in MDS patients.Flow cytometry integration of bone marrow cells in patients with abnormal immune phenotype can provide reliable and objective data on the treatment and prognosis evaluation.
出处
《临床和实验医学杂志》
2017年第2期190-193,共4页
Journal of Clinical and Experimental Medicine
