中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2011年
4期
234-238
,共5页
李丽娟%付蓉%王化泉%岳兰竹%刘惠%王珺%王红蕾%阮二宝%瞿文%梁勇%王国锦%王晓明%刘鸿%宋嘉%吴玉红%邢莉民%关晶%邵宗鸿
李麗娟%付蓉%王化泉%嶽蘭竹%劉惠%王珺%王紅蕾%阮二寶%瞿文%樑勇%王國錦%王曉明%劉鴻%宋嘉%吳玉紅%邢莉民%關晶%邵宗鴻
리려연%부용%왕화천%악란죽%류혜%왕군%왕홍뢰%원이보%구문%량용%왕국금%왕효명%류홍%송가%오옥홍%형리민%관정%소종홍
骨髓增生异常综合征%抗原,CD34%原癌基因蛋白质c-kit%受体,红细胞生成素%受体,粒细胞集落刺激因子
骨髓增生異常綜閤徵%抗原,CD34%原癌基因蛋白質c-kit%受體,紅細胞生成素%受體,粒細胞集落刺激因子
골수증생이상종합정%항원,CD34%원암기인단백질c-kit%수체,홍세포생성소%수체,립세포집락자격인자
Myelodysplastic syndromes%Antigens,CD34%Proto-oncogene protein c-kit%Receptors,erythropoietin%Receptors,granulocyte colony-stimulating factor
目的 探讨骨髓增生异常综合征(MDS)患者骨髓CD34+细胞亚群及其表面干细胞因子受体(SCF-R)、红细胞生成素受体(EpoR)、粒细胞集落刺激因子受体(G-CSFR)及血小板生成素受体(TpoR)的表达情况及其意义.方法 采用流式细胞术检测2008年7月至2010年3月天津医科大学总医院新诊断的45例MDS患者(17例低危患者、28例高危患者)及30名对照组原代骨髓CD34+CD38+及CD34+CD38-细胞亚群及其表面SCF-R、EpoR、G-CSFR及TpoR的表达率.结果 高危组CD34+细胞比例[0.53%(0.10%～1.68%)]明显高于对照组[0.13%(0.08%～0.32%),P＜0.01],其他2组间比较差异无统计学意义.低危组和高危组CD34+CD38+细胞比例(86.3%±8.5%、82.6%±11.1%)显著低于对照组(92.3%±3.4%,均P＜0.05),而CD34+CD38-细胞比例(13.7%±8.5%、17.4%±11.0%)显著高于对照组(7.7%±3.4%,均P＜0.05).对照组骨髓CD34+CD38+细胞亚群EpoR表达率(18.7%±18.3%)显著低于CD34+CD38-细胞亚群(63.6%±20.0%,P＜0.01),两亚群之间SCF-R、G-CSFR及TpoR表达率差异无统计学意义.在CD34+CD38+细胞亚群中,3组间SCF-R和TpoR表达率差异无统计学意义,而低危组和高危组EpoR的表达率[9.0%(1.4%～12.7%)、5.2%(1.1%～14.1%)]明显低于对照组[9.6%(5.1%～30.1%),均P＜0.05],G-CSFR的表达率(29.8%±19.1%、28.7%±21.1%)明显低于对照组(44.4%±23.4%,均P＜0.05);在CD34+CD38-细胞亚群中,3组间SCF-R和G-CSFR表达率差异无统计学意义,低危组和高危组EpoR的表达率(42.2%±21.9%、25.7%±15.6%)明显低于对照组(63.6%±20.0%,均P＜0.01),TpoR的表达率(5.4%±4.7%、4.1%±4.0%)明显低于对照组(10.1%±8.3%,均P＜0.05).MDS患者骨髓CD34+CD38+和CD34+CD38-细胞亚群表面受体表达率低的患者其外周血血红蛋白水平、中性粒细胞及血小板计数减低的发生率明显高于受体表达率不低的患者(均P＜0.05).结论 MDS患者的原代骨髓CD34+细胞亚群分化异常,膜表面部分造血细胞因子受体表达减低,这可能与MDS患者血细胞减少有关,有望用于辅助诊断MDS.
目的 探討骨髓增生異常綜閤徵(MDS)患者骨髓CD34+細胞亞群及其錶麵榦細胞因子受體(SCF-R)、紅細胞生成素受體(EpoR)、粒細胞集落刺激因子受體(G-CSFR)及血小闆生成素受體(TpoR)的錶達情況及其意義.方法 採用流式細胞術檢測2008年7月至2010年3月天津醫科大學總醫院新診斷的45例MDS患者(17例低危患者、28例高危患者)及30名對照組原代骨髓CD34+CD38+及CD34+CD38-細胞亞群及其錶麵SCF-R、EpoR、G-CSFR及TpoR的錶達率.結果 高危組CD34+細胞比例[0.53%(0.10%～1.68%)]明顯高于對照組[0.13%(0.08%～0.32%),P＜0.01],其他2組間比較差異無統計學意義.低危組和高危組CD34+CD38+細胞比例(86.3%±8.5%、82.6%±11.1%)顯著低于對照組(92.3%±3.4%,均P＜0.05),而CD34+CD38-細胞比例(13.7%±8.5%、17.4%±11.0%)顯著高于對照組(7.7%±3.4%,均P＜0.05).對照組骨髓CD34+CD38+細胞亞群EpoR錶達率(18.7%±18.3%)顯著低于CD34+CD38-細胞亞群(63.6%±20.0%,P＜0.01),兩亞群之間SCF-R、G-CSFR及TpoR錶達率差異無統計學意義.在CD34+CD38+細胞亞群中,3組間SCF-R和TpoR錶達率差異無統計學意義,而低危組和高危組EpoR的錶達率[9.0%(1.4%～12.7%)、5.2%(1.1%～14.1%)]明顯低于對照組[9.6%(5.1%～30.1%),均P＜0.05],G-CSFR的錶達率(29.8%±19.1%、28.7%±21.1%)明顯低于對照組(44.4%±23.4%,均P＜0.05);在CD34+CD38-細胞亞群中,3組間SCF-R和G-CSFR錶達率差異無統計學意義,低危組和高危組EpoR的錶達率(42.2%±21.9%、25.7%±15.6%)明顯低于對照組(63.6%±20.0%,均P＜0.01),TpoR的錶達率(5.4%±4.7%、4.1%±4.0%)明顯低于對照組(10.1%±8.3%,均P＜0.05).MDS患者骨髓CD34+CD38+和CD34+CD38-細胞亞群錶麵受體錶達率低的患者其外週血血紅蛋白水平、中性粒細胞及血小闆計數減低的髮生率明顯高于受體錶達率不低的患者(均P＜0.05).結論 MDS患者的原代骨髓CD34+細胞亞群分化異常,膜錶麵部分造血細胞因子受體錶達減低,這可能與MDS患者血細胞減少有關,有望用于輔助診斷MDS.
목적 탐토골수증생이상종합정(MDS)환자골수CD34+세포아군급기표면간세포인자수체(SCF-R)、홍세포생성소수체(EpoR)、립세포집락자격인자수체(G-CSFR)급혈소판생성소수체(TpoR)적표체정황급기의의.방법 채용류식세포술검측2008년7월지2010년3월천진의과대학총의원신진단적45례MDS환자(17례저위환자、28례고위환자)급30명대조조원대골수CD34+CD38+급CD34+CD38-세포아군급기표면SCF-R、EpoR、G-CSFR급TpoR적표체솔.결과 고위조CD34+세포비례[0.53%(0.10%～1.68%)]명현고우대조조[0.13%(0.08%～0.32%),P＜0.01],기타2조간비교차이무통계학의의.저위조화고위조CD34+CD38+세포비례(86.3%±8.5%、82.6%±11.1%)현저저우대조조(92.3%±3.4%,균P＜0.05),이CD34+CD38-세포비례(13.7%±8.5%、17.4%±11.0%)현저고우대조조(7.7%±3.4%,균P＜0.05).대조조골수CD34+CD38+세포아군EpoR표체솔(18.7%±18.3%)현저저우CD34+CD38-세포아군(63.6%±20.0%,P＜0.01),량아군지간SCF-R、G-CSFR급TpoR표체솔차이무통계학의의.재CD34+CD38+세포아군중,3조간SCF-R화TpoR표체솔차이무통계학의의,이저위조화고위조EpoR적표체솔[9.0%(1.4%～12.7%)、5.2%(1.1%～14.1%)]명현저우대조조[9.6%(5.1%～30.1%),균P＜0.05],G-CSFR적표체솔(29.8%±19.1%、28.7%±21.1%)명현저우대조조(44.4%±23.4%,균P＜0.05);재CD34+CD38-세포아군중,3조간SCF-R화G-CSFR표체솔차이무통계학의의,저위조화고위조EpoR적표체솔(42.2%±21.9%、25.7%±15.6%)명현저우대조조(63.6%±20.0%,균P＜0.01),TpoR적표체솔(5.4%±4.7%、4.1%±4.0%)명현저우대조조(10.1%±8.3%,균P＜0.05).MDS환자골수CD34+CD38+화CD34+CD38-세포아군표면수체표체솔저적환자기외주혈혈홍단백수평、중성립세포급혈소판계수감저적발생솔명현고우수체표체솔불저적환자(균P＜0.05).결론 MDS환자적원대골수CD34+세포아군분화이상,막표면부분조혈세포인자수체표체감저,저가능여MDS환자혈세포감소유관,유망용우보조진단MDS.
Objective To detect the abnormalities of differentiation and expression of membrane hemopoietic cytokine receptors on CD34 + bone marrow cells in patients with myelodysplastic syndromes (MDS). Methods Forty-five newly diagnosed MDS cases from July 2008 to March 2010 in our hospitaland 30 normal controls were enrolled. There were 17 low-risk and 28 high-risk patients. The CD34 + CD38 +and CD34 + CD38- bone marrow cells and the expressions of stem cell factor receptor (SCF-R),erythropoietin receptor (EpoR), granulocyte colony-stimulating factor receptors (G-CSFR) and thrombopoietin receptor (TpoR) on those cells were measured by flow cytometry. Results The mean percentage of CD34+ in karyocyte of MDS cases in high-risk patients [0. 53% (0. 10% - 1.68% )] was significantly higher than that of control group [0. 13% ( 0. 08% - 0. 32% ), P ＜ 0. 01] . The mean percentages of CD34 + CD38 + cells were significantly lower in low and high-risk groups (86. 3% ± 8.5% and 82. 6% ± 11.1% ) than those in control group (92. 3% ± 3.4% ). And the percentage of CD34+ CD38-cells was significantly higher in either low-risk or high-risk group ( 13.7% ±8. 5% and 17.4% ± 11.0% )than that in control group (7.7% ± 3.4%, both P ＜ 0. 05 ). In control group, the mean percentage of antigen expression of EpoR was significantly lower in CD34 + CD38 + cells than that in CD34 + CD38 - cells ( 18.7% ± 18. 3% vs 63. 6% ±20. 0%, P ＜0. 01 ). The expressions of SCF-R, G-CSFR and TpoR were not significantly different between two cell populations. The expressions of EpoR on CD34 + CD38 + cells of low and high-risk MDS groups [9.0% ( 1.4% - 12. 7% ), 5. 2% ( 1.1% - 14. 1% )] were significantly lower than those of control group [9. 6% (5.1% - 30. 1% ), both P ＜ 0. 05]. The expressions of G-CSFR on CD34+CD38+ cells of low and high-risk MDS groups (29.8% ± 19. 1%, 28.7% ± 21.1%) were significantly lower than those of control group (44.4% ± 23.4%, both P ＜ 0. 05 ). The quantities of EpoR on CD34 + CD38 - cells of low and high-risk MDS groups ( 42. 2% ± 21.9%, 25.7% ± 15. 6% ) were significantly lower than those of control group ( 63. 6% ± 20. 0%, both P ＜ 0. 01 ). The expressions of TpoR on CD34+ CD38- cells of low and high-risk MDS groups (5.4% ± 4.7%, 4.1% ± 4.0%) were significantly lower than those of control group ( 10. 1% ± 8. 3%, both P ＜ 0. 05 ). The incidence of cytopenia with low expression rates of hemopoietic cytokine receptors on CD34 + cells was higher than that of MDS with high expression rates. Conclusion The abnormalities of differentiation and membrane hemopoietic cytokine receptors expression of CD34 + bone marrow cells in MDS are associated with MDS cytopenia and may be useful for the diagnosis of MDS.
