中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2010年
11期
963-966
,共4页
李丽娟%付蓉%邵宗鸿%王化泉%岳兰竹%阮二宝%刘惠%王珺%王红蕾
李麗娟%付蓉%邵宗鴻%王化泉%嶽蘭竹%阮二寶%劉惠%王珺%王紅蕾
리려연%부용%소종홍%왕화천%악란죽%원이보%류혜%왕군%왕홍뢰
骨髓增生异常综合征%CD34%CD38%细胞周期
骨髓增生異常綜閤徵%CD34%CD38%細胞週期
골수증생이상종합정%CD34%CD38%세포주기
Myelodysplastic syndrome%CD34%CD38%Cell cycle
目的 探讨骨髓增生异常综合征(MDS)患者骨髓CD34+细胞亚群及细胞周期分布异常的临床意义.方法 采用流式细胞术检测50例(17例低危、33例高危)MDS患者、8例MDS转化的急性髓系自血病(MDS-AML)及25例对照组原代骨髓CD34+CD38+、CD34+CD38-细胞亚群及G0/G1期、S期和G2/M期细胞比例.结果 高危和MDS-AML组骨髓CD34+细胞比例[(2.29±2.17)%、(18.69±17.47)%]明显高于对照组[(0.36±0.49)%,P＜0.05].低危、高危及MDS-AML组CD34+CD38+细胞相对比例[(86.09±7.79)%、(81.68±11.82)%、(82.88±2.60)%]显著低于对照组[(92.21±3.85)%,P＜0.05],而CD34+CD38-细胞比例[(13.91±7.79)%、(18.32±11.82)%、(17.13±2.60)%]显著高于对照组[(7.79±3.85)%,P＜0.05].MDS组CD34+CD38-细胞比例与国际预后积分系统(IPSS)(r=0.493,P=0.001)、WHO分型预后积分系统(WPSS)积分(r=0.586,P=0.000)均呈正相关.低危、高危及MDS-AML组骨髓单个核细胞(BMMNC)中G0/G1期细胞比例[(94.52±4.32)%,(96.07±3.88)%,(94.65±4.55)%]明显高于对照组[(88.94±7.30)%,P＜0.01],而3组S期[(4.63±3.34)%,(3.45±3.80)%,(5.12±4.55)%]和G2/M期[(0.84±1.52)%,(0.48±0.74)%,(0.22±0.34)%]细胞比例明显低于对照组[(9.06±6.50)%,(2.00±2.93)%,P值均＜0.05],3组S+G2/M期细胞比例明显高于对照组(P＜0.01).CD34+CD38-细胞比例≤12.0%的MDS患者治疗有效率高于CD34+CD38-细胞比例＞12.0%的患者,但差异无统计学意义.结论 MDS患者原代骨髓CD34+细胞亚群分化异常,BMMNC存在G1期阻滞现象,提示CD34+细胞亚群和细胞周期测定可能有助于MDS患者的辅助诊断以及疗效和预后判断.
目的 探討骨髓增生異常綜閤徵(MDS)患者骨髓CD34+細胞亞群及細胞週期分佈異常的臨床意義.方法 採用流式細胞術檢測50例(17例低危、33例高危)MDS患者、8例MDS轉化的急性髓繫自血病(MDS-AML)及25例對照組原代骨髓CD34+CD38+、CD34+CD38-細胞亞群及G0/G1期、S期和G2/M期細胞比例.結果 高危和MDS-AML組骨髓CD34+細胞比例[(2.29±2.17)%、(18.69±17.47)%]明顯高于對照組[(0.36±0.49)%,P＜0.05].低危、高危及MDS-AML組CD34+CD38+細胞相對比例[(86.09±7.79)%、(81.68±11.82)%、(82.88±2.60)%]顯著低于對照組[(92.21±3.85)%,P＜0.05],而CD34+CD38-細胞比例[(13.91±7.79)%、(18.32±11.82)%、(17.13±2.60)%]顯著高于對照組[(7.79±3.85)%,P＜0.05].MDS組CD34+CD38-細胞比例與國際預後積分繫統(IPSS)(r=0.493,P=0.001)、WHO分型預後積分繫統(WPSS)積分(r=0.586,P=0.000)均呈正相關.低危、高危及MDS-AML組骨髓單箇覈細胞(BMMNC)中G0/G1期細胞比例[(94.52±4.32)%,(96.07±3.88)%,(94.65±4.55)%]明顯高于對照組[(88.94±7.30)%,P＜0.01],而3組S期[(4.63±3.34)%,(3.45±3.80)%,(5.12±4.55)%]和G2/M期[(0.84±1.52)%,(0.48±0.74)%,(0.22±0.34)%]細胞比例明顯低于對照組[(9.06±6.50)%,(2.00±2.93)%,P值均＜0.05],3組S+G2/M期細胞比例明顯高于對照組(P＜0.01).CD34+CD38-細胞比例≤12.0%的MDS患者治療有效率高于CD34+CD38-細胞比例＞12.0%的患者,但差異無統計學意義.結論 MDS患者原代骨髓CD34+細胞亞群分化異常,BMMNC存在G1期阻滯現象,提示CD34+細胞亞群和細胞週期測定可能有助于MDS患者的輔助診斷以及療效和預後判斷.
목적 탐토골수증생이상종합정(MDS)환자골수CD34+세포아군급세포주기분포이상적림상의의.방법 채용류식세포술검측50례(17례저위、33례고위)MDS환자、8례MDS전화적급성수계자혈병(MDS-AML)급25례대조조원대골수CD34+CD38+、CD34+CD38-세포아군급G0/G1기、S기화G2/M기세포비례.결과 고위화MDS-AML조골수CD34+세포비례[(2.29±2.17)%、(18.69±17.47)%]명현고우대조조[(0.36±0.49)%,P＜0.05].저위、고위급MDS-AML조CD34+CD38+세포상대비례[(86.09±7.79)%、(81.68±11.82)%、(82.88±2.60)%]현저저우대조조[(92.21±3.85)%,P＜0.05],이CD34+CD38-세포비례[(13.91±7.79)%、(18.32±11.82)%、(17.13±2.60)%]현저고우대조조[(7.79±3.85)%,P＜0.05].MDS조CD34+CD38-세포비례여국제예후적분계통(IPSS)(r=0.493,P=0.001)、WHO분형예후적분계통(WPSS)적분(r=0.586,P=0.000)균정정상관.저위、고위급MDS-AML조골수단개핵세포(BMMNC)중G0/G1기세포비례[(94.52±4.32)%,(96.07±3.88)%,(94.65±4.55)%]명현고우대조조[(88.94±7.30)%,P＜0.01],이3조S기[(4.63±3.34)%,(3.45±3.80)%,(5.12±4.55)%]화G2/M기[(0.84±1.52)%,(0.48±0.74)%,(0.22±0.34)%]세포비례명현저우대조조[(9.06±6.50)%,(2.00±2.93)%,P치균＜0.05],3조S+G2/M기세포비례명현고우대조조(P＜0.01).CD34+CD38-세포비례≤12.0%적MDS환자치료유효솔고우CD34+CD38-세포비례＞12.0%적환자,단차이무통계학의의.결론 MDS환자원대골수CD34+세포아군분화이상,BMMNC존재G1기조체현상,제시CD34+세포아군화세포주기측정가능유조우MDS환자적보조진단이급료효화예후판단.
Objectives To detect the abnormalities of CD34+ cells differentiation and bone marrow cell cycle in myelodysplastic syndrome (MDS). Methods Fifty newly diagnosed MDS ( 17 in low risk and 33 in high risk), 8 acute myeloid leukemia preceded by MDS (MDS-AML) and 25 normal controls were enrolled into this study. Their CD34+ CD38+, CD34+CD38- bone marrow cells and bone marrow cell cycle were measured with flow cytometry. Results The mean percentages of CD34+ cells in bone marrow karyocyte of high risk [ (2.29 ±2.17)% ] and MDS-AML groups [ ( 18.69 ± 17.47)% ] were significantly higher than that of control group [ ( 0.36 ± 0.49 )%, P ＜ 0.05 ]. The mean percentages of CD34+CD38+ cells were significantly lower in low risk, high risk and MDS-AML groups [ ( 86.09 ± 7.79 )%, ( 81.68 ± 11.82)% and (82.88 ±2.60)%, respectively] than that in control group [ (92.21 ±3.85)%, P＜0.05], thus the percentages of CD34+CD38- cells were significantly higher in either MDS (low risk and high risk) or MDS-AML groups [ (13.91 ±7.79)%, (18.32 ±11.82)% or (17.13 ±2.60)%, respectively] than that in control group [ (7.79 ± 3.85 )%, P ＜ 0.05 ]. The percentages of CD+34 CD-38 cells of MDS cases correlated directly with their International Prognostic Scoring System (IPSS) (r =0.493, P =0.001 ) and WHO Adapted Prognostic Scoring System (WPSS) ( r = 0.586, P = 0.000 ) scores. The percentages of bone marrow mononuclea cells (BMMNCs) in G0/G1 phase of in low risk, high risk and MDS-AML groups [ (94.52 ±4.32)%, (96.07 ± 3.88 )% and (94.65 ± 4.55 )%, respectively ] were significantly higher than that in control group[ (88.94 ±7.30)%, P ＜0.01 ], thus the percentages of BMMNCs in S and G2/M phase were significantly lower in either MDS (low risk and high risk) or MDS-AML groups than that in control group (P＜0.05). MDS patients with low percentages of CD34+CD38- cells presented higher therapeutic efficacy than those with high percentages of CD34+CD38- cells, while without significant differences ( P ＞ 0.05 ) .Conclusions There are abnormalities of differentiation of CD34+ bone marrow cells and high proportion of G0/G1 cells which indicates a G1 phase arrest in MDS that might be involved in the pathogenesis of MDS. So the examination of CD34+ bone marrow cells and cell cycle might be helpful for MDS diagnosis and assessment of prognosis and therapeutic effects.
