CAJ | 학술논문

目的探讨病态造血细胞与细胞遗传学改变对骨髓增生异常综合征(MDS)诊断及分型的意义.方法对133例MDS患者行常规骨髓穿刺及外周血涂片瑞特染色,观察MDS各亚型各系列细胞的病态造血特点；同时行染色体核型分析,并结合病态细胞与染色体核型异常改变,分析MDS各亚型与之关联.结果以检出病态细胞≥0.10为界,粒、红、巨核三系总检出率为43.4％,对低危[难治性贫血(RA)+难治性贫血伴有环铁粒幼红细胞( RARS)]、中危[难治性血细胞减少伴有多系发育异常( RCMD )]及高危[难治性贫血伴有原始细胞过多(RAEB)]三组进行比较,病态粒细胞及病态巨核细胞≥0.10者主要见于RCMD(P＜0.01),病态红细胞≥0.10者主要见于RA+RARS( P＜ 0.01).MDS染色体核型异常总检测率44.0％,虽异常核型检出率RA及RARS组低干其他各亚型,但差异无统计学意义(P＞0.05).病态细胞及染色体核型异常检出与MDS亚型间关系表现为:RA组核型异常且同时具有病态细胞≥0.10者占50.0％(3/6),RCMD组占76.0％(19/25),RAEB组占60.9％(14/23)(P＜0.01).结论染色体核型异常同时具有病态细胞≥0.10者显示与MDS亚型有关联；密切监测造血及细胞遗传学改变对确诊MDS有帮助.
목적 탐토병태조혈세포여세포유전학개변대골수증생이상종합정(MDS)진단급분형적의의.방법 대133례MDS환자행상규골수천자급외주혈도편서특염색,관찰MDS각아형각계렬세포적병태조혈특점；동시행염색체핵형분석,병결합병태세포여염색체핵형이상개변,분석MDS각아형여지관련.결과 이검출병태세포≥0.10위계,립、홍、거핵삼계총검출솔위43.4％,대저위[난치성빈혈(RA)+난치성빈혈반유배철립유홍세포( RARS)]、중위[난치성혈세포감소반유다계발육이상( RCMD )]급고위[난치성빈혈반유원시세포과다(RAEB)]삼조진행비교,병태립세포급병태거핵세포≥0.10자주요견우RCMD(P＜0.01),병태홍세포≥0.10자주요견우RA+RARS( P＜ 0.01).MDS염색체핵형이상총검측솔44.0％,수이상핵형검출솔RA급RARS조저간기타각아형,단차이무통계학의의(P＞0.05).병태세포급염색체핵형이상검출여MDS아형간관계표현위:RA조핵형이상차동시구유병태세포≥0.10자점50.0％(3/6),RCMD조점76.0％(19/25),RAEB조점60.9％(14/23)(P＜0.01).결론 염색체핵형이상동시구유병태세포≥0.10자현시여MDS아형유관련；밀절감측조혈급세포유전학개변대학진MDS유방조.
Objective To explore the significance of dysplasia and cytogenetic changes to the diagnosis and typing of myelodysplastic syndrome (MDS).Methods The dysplasia performance of each series in every isoforms was observed by the bone marrow aspiration and peripheral blood smear to the 132 patients with MDS. At the same time do the chromosome karyotype was analizad combined with morbidness cells and chromosome karyotype abnormal analysis associated with MDS subtype. Resuits Acorrding to the dysplasia ≥0.10, the totle detection rate of granulocyte series, erythrocyte series and megakaryocytic was 43.4 ％.The morbidness granulocyte and megalokaryocyte ≥0.10was mainly in RCMD (P ＜ 0.01); morbidness erythrocytes≥0.10 mainly in RA + RARS (P ＜ 0.01). the totle detection rate of chromosome karyotype abnormal in MDS was 44.0 ％.The detection rate in RA and RARS was lower than other isoforms,but showed no statistically significant (P ＞ 0.05).the relationships of dysplasia and chromosome karyotype abnormal with the isoforms of MDS:in RA group,50.0 ％(3/6) patients had karyotype abnormal simultaneous the detection of morbidness cells≥0.10, 76.0 ％(19/25) in RCMD group and 60.9 ％(14/23) in RAEB group (P ＜ 0.01).Conclusion Theve is relationships between the patients with chromosome karyotype abnormal and dysplasia ≥0.10 and the isoforms of MDS. Closely monitoring the hemopoiesis and cytogenetic changes is significance to diagnose MDS.