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目的:探讨骨髓增生异常综合征(MDS)患者原始细胞免疫表型特点及其在诊断、分型及预后中的临床意义。方法:应用多参数流式细胞术,对41例MDS患者和24例非MDS患者原始细胞免疫标志的表达率进行检测。结果:MDS组与非MDS(non-MDS)组相比,CD34、CD123和CD133在原始细胞群表达显著增高(P<0.01),CD38、HLA-DR、CD13、CD33、CD7和CD117表达均无显著差异(P>0.05);CD34在难治性血细胞减少伴有多系发育异常(RCMD)、难治性贫血伴有原始细胞增多-Ⅰ(RAEB-Ⅰ)和难治性贫血伴有原始细胞增多-Ⅱ(RAEB-Ⅱ)亚型间表达逐渐升高,在RCMD与RAEB-Ⅰ、RCMD与RAEB-Ⅱ及RAEB-Ⅰ与RAEB-Ⅱ亚型间表达有显著差异(P<0.05),CD133、CD117、CD13和HLA-DR在RAEB-Ⅱ表达比RCMD显著增高(P<0.05);其余抗原亚型间比较均无显著差异(P>0.05)。结论:多参数FCM能够检测到MDS患者原始细胞异常免疫表型特点,为临床对MDS患者诊断、鉴别诊断及预后评价提供更多客观的信息。
Objective: To investigate the characteristics of the immunophenotype of myelodysplastic syndrome (MDS) patients and their clinical significance in diagnosis, classification and prognosis. Methods: The multi-parameter flow cytometry was used to detect the expression of immunofluorescent markers in 41 MDS patients and 24 non-MDS patients. Results: Compared with non-MDS group, the expression of CD34, CD123 and CD133 in MDS group was significantly increased (P <0.01), but no expression of CD38, HLA-DR, CD13, CD33, CD7 and CD117 (RCMD), refractory anemia accompanied by primitive cell proliferation-Ⅰ (RAEB-Ⅰ) and refractory anemia accompanied by primitive cells There was a significant difference (P <0.05) between RCA and RAEB-Ⅰ, RCMD and RAEB-Ⅱ and between RAEB-Ⅰ and RAEB-Ⅱ subtypes. The expression of CD133 , While the expression of CD117, CD13 and HLA-DR in RAEB-Ⅱ was significantly higher than that in RCMD (P <0.05). There was no significant difference in the other antigen subtypes (P> 0.05). Conclusion: The multi-parameter FCM can detect abnormal immunophenotypic features of blast cells in MDS patients and provide more objective information for clinical diagnosis, differential diagnosis and prognosis evaluation of MDS patients.