白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2012年
5期
297-299
,共3页
程虹%杜伟%江明%郝建萍%陈双%钟笛%马遇庆%李玲
程虹%杜偉%江明%郝建萍%陳雙%鐘笛%馬遇慶%李玲
정홍%두위%강명%학건평%진쌍%종적%마우경%리령
骨髓增生异常综合征%细胞形态学%染色体核型%免疫表型分型%活组织检查
骨髓增生異常綜閤徵%細胞形態學%染色體覈型%免疫錶型分型%活組織檢查
골수증생이상종합정%세포형태학%염색체핵형%면역표형분형%활조직검사
Myelodysplastic syndrome%Morphology%XYY karyotype%Immunol phenmotyping%Biopsy
目的 依据世界卫生组织(WHO)标准对249例骨髓增生异常综合征(MDS)进行诊断分型.方法 根据WHO(2008)标准对249例MDS行细胞形态学、细胞遗传学、免疫表型分析及骨髓病理活组织检查诊断.结果 所有MDS病例外周血成熟红细胞均见有巨大形与椭圆形改变;幼红、幼粒细胞、Pelger样核异常细胞与无颗粒中性粒细胞检出率随分型进展而增高;骨髓发育异常细胞特点及比例随MDS亚型进展而更明显、更高;经动态随访观察,MDS随分型进展其转急性白血病(AL)率增高(P<0.05);148例患者行免疫表型分析,随分型进展髓系特异性抗原(CD33)表达逐渐增加;138例患者行染色体检查,其中异常核型表达53例(38.7%),主要见于20q-和+8,复杂异常核型16例(28%),其中5q-2例;180例患者同时行骨髓活组织检查,19例具有形态异常,符合MDS诊断,42例伴有骨髓纤维化.结论 依据WHO标准多指标联合检测MDS有助于更准确的分型及诊断,进行长期追踪随访有助于判断预后.
目的 依據世界衛生組織(WHO)標準對249例骨髓增生異常綜閤徵(MDS)進行診斷分型.方法 根據WHO(2008)標準對249例MDS行細胞形態學、細胞遺傳學、免疫錶型分析及骨髓病理活組織檢查診斷.結果 所有MDS病例外週血成熟紅細胞均見有巨大形與橢圓形改變;幼紅、幼粒細胞、Pelger樣覈異常細胞與無顆粒中性粒細胞檢齣率隨分型進展而增高;骨髓髮育異常細胞特點及比例隨MDS亞型進展而更明顯、更高;經動態隨訪觀察,MDS隨分型進展其轉急性白血病(AL)率增高(P<0.05);148例患者行免疫錶型分析,隨分型進展髓繫特異性抗原(CD33)錶達逐漸增加;138例患者行染色體檢查,其中異常覈型錶達53例(38.7%),主要見于20q-和+8,複雜異常覈型16例(28%),其中5q-2例;180例患者同時行骨髓活組織檢查,19例具有形態異常,符閤MDS診斷,42例伴有骨髓纖維化.結論 依據WHO標準多指標聯閤檢測MDS有助于更準確的分型及診斷,進行長期追蹤隨訪有助于判斷預後.
목적 의거세계위생조직(WHO)표준대249례골수증생이상종합정(MDS)진행진단분형.방법 근거WHO(2008)표준대249례MDS행세포형태학、세포유전학、면역표형분석급골수병리활조직검사진단.결과 소유MDS병예외주혈성숙홍세포균견유거대형여타원형개변;유홍、유립세포、Pelger양핵이상세포여무과립중성립세포검출솔수분형진전이증고;골수발육이상세포특점급비례수MDS아형진전이경명현、경고;경동태수방관찰,MDS수분형진전기전급성백혈병(AL)솔증고(P<0.05);148례환자행면역표형분석,수분형진전수계특이성항원(CD33)표체축점증가;138례환자행염색체검사,기중이상핵형표체53례(38.7%),주요견우20q-화+8,복잡이상핵형16례(28%),기중5q-2례;180례환자동시행골수활조직검사,19례구유형태이상,부합MDS진단,42례반유골수섬유화.결론 의거WHO표준다지표연합검측MDS유조우경준학적분형급진단,진행장기추종수방유조우판단예후.
Objective To diagnose and classify 249 patients with myelodysplastic syndrome (MDS) according to the WHO standards.Methods According to the WHO standards,cell morphology,cytogenetics,immune phenotype and bone marrow pathologic biopsy in 249 cases of MDS were analyzed.Results Great shape and oval cell of mature erythrocyte could be observed in all MDS patients peripheral blood. The incidence of immature erythrocyte,immature granulocyte,pelger-like abnormal nucleus and neutrophils cells without granular increased with subtypes progressing.These abnormal characteristics and proportion tended to more apparent with MDS subtypes progressing.With the dynamic follow-up,we found the rate of MDS transition to AL increased with subtypes progressing(P<0.05 ).The immune phenotype analysis of 148 patients was undertook and found that the trend to express myeloid specific antigen (CD33) increased gradually with subtypes progressing The chromosome inspection in 138 patients was undertook and found that 53 patients (38.7 % with abnormal karyotype,mainly in 20q- and +8; 16 cases with complex abnormal karyotype (28 %), two patients in 5q-. 180 patients were underwent bone marrow biopsy at the same time and found that 19 patients with abnormal morphology; 42 patients with bone marrow fibrosis.Conclusions Combining with multiple index to detect the MDS contributes to the classification and diagnosis more accuratcly and long-term follow-up helps to judgment the prognosis.