CAJ | 학술논문

目的研究骨髓增生异常综合征(MDS)患者骨髓原始细胞免疫表型及叶酸受体(FR)的表达.方法应用四色流式细胞术对常规及二次设门选取的MDS患者骨髓原始细胞、CD+34原始细胞进行免疫表型分析及叶酸受体的表达检测,并以急性髓系白血病M2型(AML-M2)作阳性对照.结果:随着MDS疾病的进展(RA/RAS→RAEB→RAEB-T),应用常规设门选取的原始细胞中CD+34原始细胞比例逐渐升高,各亚型间差异有统计学意义(P<0.05);HLA-DR及髓系抗原CD117、CD13、CD33表达逐渐增高,CD15表达逐渐降低,差异有统计学意义(P＜0.05).而应用二次设门取CD+34原始细胞行抗原表达分析,同样异常表达HLA-DR及髓系抗原CD117、CD13、CD33且表达率高于常规分析法(P＜0.05),但各相关抗原表达率在各亚型间差异无统计学意义(P＞0.05).用常规方法直接提取的MDS各亚型的原始细胞及二次设门提取的CD+34原始细胞上均未得到FR表达阳性的细胞.结论随着 MDS疾病的进展,原始细胞表面抗原向髓系更加不成熟的表型转变,但髓系抗原的异常表达只反映了优势恶性克隆数量上的增加而不能真正反映疾病进展的本质.单纯应用流式细胞技术尚不能检测出MDS原始细胞上是否存在叶酸受体的表达.
목적 연구골수증생이상종합정(MDS)환자골수원시세포면역표형급협산수체(FR)적표체.방법 응용사색류식세포술대상규급이차설문선취적MDS환자골수원시세포、CD+34원시세포진행면역표형분석급협산수체적표체검측,병이급성수계백혈병M2형(AML-M2)작양성대조.결과:수착MDS질병적진전(RA/RAS→RAEB→RAEB-T),응용상규설문선취적원시세포중CD+34원시세포비례축점승고,각아형간차이유통계학의의(P<0.05);HLA-DR급수계항원CD117、CD13、CD33표체축점증고,CD15표체축점강저,차이유통계학의의(P＜0.05).이응용이차설문취CD+34원시세포행항원표체분석,동양이상표체HLA-DR급수계항원CD117、CD13、CD33차표체솔고우상규분석법(P＜0.05),단각상관항원표체솔재각아형간차이무통계학의의(P＞0.05).용상규방법직접제취적MDS각아형적원시세포급이차설문제취적CD+34원시세포상균미득도FR표체양성적세포.결론 수착 MDS질병적진전,원시세포표면항원향수계경가불성숙적표형전변,단수계항원적이상표체지반영료우세악성극륭수량상적증가이불능진정반영질병진전적본질.단순응용류식세포기술상불능검측출MDS원시세포상시부존재협산수체적표체.
Objective To explore the immunophenotype features and folate receptor expression of blasts in patients with myelodysplastic syndromes(MDS).Methods Four-color flow cytometry using conventional and secondary gating strategies was used into analysis the immunophenotype features and folate receptor(FR) expression of blasts and CD+34 cells in bone marrow nucleated cells with MDS.The patients with acute myeloid leukemia-M2(AML-M2) were as positive control.Results with progression of MDS from RA/RAS,RAEB to RAEB-T,using conventional gating strategy,the proportion of CD+34 cells were gradually increased(P＜0.05).Moreover,the expression of HLA-DR,CDll7,CD13,CD33 were also gradually increased and the expression of CDl5 was gradually decreased(P＜0.05).Using secondary gating strategy,the expression of HLA-DR,CD117,CD13,CD33 on blasts were higher than those by conventional gating(P＜0.05).However,there was no significant difference(P＞0.05) in the expression of above mentioned antigens on CD+34 cells among different MDS subtypes.On the other hand,there were no expression of FR on blasts and cD+34 cells with different MDS subtypes.Conclusion With progression of MDS,the antigens of blasts surface change into more immature immunophenotype of medullary system.But these antigens abnormal expression only illustrates the increase of ascendant malignant clone quantity,it can not reflect the nature of the disease.Using flow cytometry technique can not detect whether or not FR expression on the blasts with MDS.