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1、骨髓增生异常综合征患者染色体核型的临床分析戚玉杨吴光启刘红张飞吕芳(南京鼓楼医院集团宿迁市人民医院血液科江苏宿迁223800)【摘要】目的:探讨染色体检测在骨髓增生异常综合征(myelodysplasticsyndromesMDS)分型及预后中的意义。方法:分析37例骨髓增生异常综合征患者的染色体核型与疾病分型、免疫表型、国际预后积分的关系。采用直接免疫荧光标记法标记经流式细胞仪测定,依据MDS的WHO分型方案、染色体核型以及系统(IPSS)将MDS患者划分为RA/RARS/RCMD组、RAEBI/RAEBII组;染色体良好组、染色体不良组;中危I组、中危I
2、I组、高危组。结果:①染色体良好组,RA/RARS/RCMD14例,RAEBI/RAEBII8例;染色体不良组中,RA/RARS/RCMD4例,RAEBI/RAEBII11例。②染色体良好组:部分患者CD34、CD117表达阳性;染色体不良组中,所有患者CD34、CD117均表达阳性,并且CD34、CD117的阳性表达率均较染色体良好组高。③染色体良好组平均国际预后积分较染色体不良组低。结论:染色体核型检测有助于MDS的分型、预后判断。【关键词】染色体;骨髓增生异常综合征【中图分类号】R394【文献标识码】A【文章编号】2095-1752(2015)28-0
3、028-02ExpressionandsignificanceofCD34,CD117onbonemarrowmononuclearcellsofmyelodysplasticsyndromesQiYuyang,WuGuangqi,LiuHong,ZhangFei,LvFang.NanjinggulouHospitalGroup,SuqianPeople'sHospital,JiangsuProvince,Suqian223800,China【Abstract】ObjectiveToexploretheexpressionandsignificanceofC
4、D34,CD117onbonemarrowmononuclearcellsofmyelodysplasticsyndromes(MDS).MethodsDirectimmunofluorescencestainingwereusedbymeansofFlowcytometry.37patientswithMDSweredividedintoRA/RARS/RCMDsubgroup,RAEBl/RAEBIIsubgroup;favorablechromosomalsubgroup,poorchromosomalsubgroup;intermediate-ris
5、kIsubgroup,intermediate-riskIIsubgroup,high-risksubgrouprespectivelyaccordingtoWorldHealthOrganizationclassification,cytogeneticabnormalitiesandInternationalPrognosticScoringSystem(IPSS).Results①CD34andCD117werepositiverespectivelyinllof19patientswithRA/RARS/RCMD,allcasesinRAEBl/RA
6、EBIIexpressedCD34andCD117;increasedexpressionofCD34andCD117wasMDSgrade-related.②favorablechromosomalsubgroup,14/22patientswerepositiveforCD34,CD117,allcasesinpoorchromosomesexpressedCD34andCD117;therewasadirectrelationshipbetweenphenotyticdensityandpoorcytogeneticriskfactor.③CD34an
7、dCD117expressionwaspresentrespectivelyinintermediate-riskI(9/17patients),intermediate-riskII(11/11)andhigh-risksubgroup(9/9);thephenotypicintensityalsowascorrelatedwithIPSSscores.ConclusionsDetectionofCD34,CD117maybeausefultoolforsubtypingandpredictingtheprognosisofMDS.【Keywords】My
8、elodysplastic;Syndromes;CD