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目的检测骨髓增生异常综合征(MDS)和再生障碍性贫血(AA)患者骨髓原始细胞免疫表型特征,探讨其对二者发病机制、诊断、分型诊断及鉴别诊断的临床意义。方法选用多种单克隆抗体,应用直接免疫荧光法、流式细胞术和CD45/SSC设门,对MDS组23例、AA组14例、正常对照组9例的骨髓原始细胞各免疫标志的表达率进行检测。结果MDS组与正常对照组相比其造血干/祖细胞抗原CD34、HLA-DR、髓系早期抗原CD13、CD33、单核系抗原CD14、T淋巴细胞抗原CD7的表达率增高,髓系成熟抗原CD15、B淋巴系抗原CD19、CD20的表达率降低,DI值增高(P<0.05);RAEB组与RA组相比CD34、HLA-DR、CD13、CD33、CD14、CD7的表达率增高,CD15、CD3、CD19、CD20的表达率减低,DI值增高(P<0.05)。AA组与正常对照组相比其CD34、CD13、CD33、CD15的表达率降低,CD3、CD7、CD25、CD22的表达率增高(P<0.05)。MDS组与AA组相比其CD34、HLA-DR、CD13、CD33、CD14的表达率增高,CD3、CD5、CD7、CD15、CD19、CD20、CD22、CD25的表达率显著降低(P<0.05)。结论MDS和AA患者骨髓细胞免疫表型分析,有助于揭示二者的发病机制,为临床提供新的诊断、分型及鉴别诊断方法。
OBJECTIVE: To detect the immunophenotypic features of bone marrow blast cells in patients with myelodysplastic syndrome (MDS) and aplastic anemia (AA) and to explore its clinical significance in the pathogenesis, diagnosis, classification and differential diagnosis of both. Methods Various monoclonal antibodies were used in this study. Immunohistofluorescence, flow cytometry and CD45 / SSC gating were used to detect the expression of various immune markers in 23 cases of MDS group, 14 cases of AA group and 9 cases of normal control group Rate for testing. Results The expression of CD34, HLA-DR, myeloid early antigen CD13, CD33, monocyte-derived antigen CD14 and T lymphocyte antigen CD7 of MDS group was higher than that of the normal control group. The myeloid mature antigen The expression of CD15, B lymphoid antigen CD19 and CD20 decreased and the DI value increased (P <0.05). The expression rates of CD34, HLA-DR, CD13, CD33, CD14 and CD7 in RAEB group were higher than those in RA group, CD3, CD19, CD20 expression decreased, DI value increased (P <0.05). Compared with the normal control group, the expression of CD34, CD13, CD33 and CD15 in AA group decreased and the expression rates of CD3, CD7, CD25 and CD22 increased (P <0.05). The expression rates of CD34, HLA-DR, CD13, CD33 and CD14 in MDS group were significantly higher than those in AA group. The expression rates of CD3, CD5, CD7, CD15, CD19, CD20, CD22 and CD25 in MDS group were significantly lower than those in AA group (P <0.05). Conclusions The immunophenotypic analysis of bone marrow cells in patients with MDS and AA may help reveal the pathogenesis of both and provide new diagnostic, classification and differential diagnosis methods for clinical diagnosis.