骨髓增生异常综合征的生物学特性和预后因素的研究

发布时间：2018-09-13 14:42

【摘要】：目的:探讨骨髓增生异常综合征(MDS)的生物学特性和预后的危险因素,重点研究不同染色体核型及免疫表型与MDS预后的联系。方法:收集本院近5年60例MDS患者临床及实验室资料,建立详细资料档案,并采用骨髓短期培养和G显带技术对60例患者进行染色体核型分析;采用流式细胞术检测其免疫表型(CD10,CD13,CD15,CD7,CD34,CD117);应用SPSS 19.0软件包进行数据处理,结合WHO2008分型及IPSS-R积分对MDS进行分组。结果:60例MDS患者中极低危12例,极高危7例;染色体异常35例(58.33%),其中5号、7号、8号、20号、Y染色体异常及复杂核型染色体所占比例分别为22.89%、20.0%、17.14%、11.43%、5.71%及14.29%;转化为白血病的正常核型占8.0%,转化为白血病的异常核型分别为复合核型占80%、8号占66.67%、7号占71.43%、5号占75.0%;极高危组MDS患者的髓系细胞表面的非成熟抗原标记CD13、CD33及CD117表达明显比极低危组MDS患者的高(P0.05),而髓系细胞表面的成熟抗原标记CD15表达率则明显比极低危组MDS患者的低(P0.05),极高危组淋巴系细胞表面抗原标记CD7、CD10表达率明显低于极低危组(P0.05)。结论:染色体核型及免疫表型对MDS患者的预后产生重要影响。
[Abstract]:Objective: to investigate the biological characteristics and prognostic risk factors of myelodysplastic syndromes (MDS), and to study the relationship between the karyotype and immunophenotype of different chromosomes and the prognosis of myelodysplastic syndromes (MDS). Methods: the clinical and laboratory data of 60 patients with MDS in our hospital in recent 5 years were collected and the detailed data files were established. The karyotype of 60 MDS patients was analyzed by bone marrow short-term culture and G-banding technique. The immunophenotype (CD10,CD13,CD15,CD7,CD34,CD117) was detected by flow cytometry, the data was processed by SPSS 19.0 software package, and the MDS was grouped by WHO2008 typing and IPSS-R integral. Results among 60 cases of MDS, 12 cases were at very low risk and 7 cases were at very high risk. There were 35 cases (58.33%) of chromosomal abnormalities, of which the proportions of chromosome 5, 7, 8 and 20 Y and complex karyotype were 22.890.20.0 and 17.14 and 11.435.71% and 14.29.1%, respectively, and the normal karyotypes transformed into leukemia accounted for 8.0%, and the abnormal karyotypes transformed into leukemia were complex karyotypes, respectively. The expression of immature antigen-labeled CD13,CD33 and CD117 on the surface of myeloid cells in the extremely high-risk group of MDS patients was significantly higher than that in the MDS patients with very low risk group (P0.05), while the expression of mature antigen CD15 on the surface of myeloid cells in the very high-risk group was significantly higher than that in the patients with very low risk group (P0.05). The rate of reaching MDS was significantly lower than that of very low risk group (P0.05), and the expression rate of CD7,CD10 on lymphoid cell surface antigen in very high-risk group was significantly lower than that in very low risk group (P0.05). Conclusion: chromosome karyotype and immunophenotype play an important role in the prognosis of MDS patients.
【作者单位】：华中科技大学同济医学院附属普爱医院血液科;
【分类号】：R551.3

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