CAJ | 학술논문

目的：探讨不同危险度骨髓增生异常综合征（myelodysplasticsymdromes，MDS）中骨髓CD34+细胞CXCR4的表达情况及其与细胞迁移率的相关性。方法：收集40例骨髓增生异常综合征患者的骨髓标本，根据IPSS积分系统进行危险度分组。低危组20例：IPSS积分0～1.5分；高危组20例：IPSS积分≥1.5分；同时采集10例健康者的骨髓标本作为对照。分离纯化骨髓CD34+细胞，通过流式细胞术检测CXCR4膜蛋白的表达；研究SDF-1α趋化作用下CD34+细胞的迁移率及CD34+细胞对骨髓基质细胞的迁移率。结果：高危组MDS患者CD34+细胞CXCR4的表达率明显高于低危组和正常对照组（P<0.0001）；低危组和正常对照组之间CXCR4的表达率无显著性差异（P>0.05）。高危组CD34+细胞对SDF-1α及骨髓基质细胞的迁移率显著高于低危组及正常组（均P<0.0001），且其对骨髓基质细胞的迁移率与CXCR4的表达呈正相关（P=0.0001）。结论：高危组MDS患者CD34+细胞CXCR4的表达量及其对骨髓基质细胞的迁移率均明显高于低危组患者，且其迁移率随CXCR4表达量的增加而升高，不同风险组的MDS患者存在SDF-1及其受体CXCR4表达和功能上的差异，SDF-1及其受体CXCR4在MDS发病中具有重要作用。
목적：탐토불동위험도골수증생이상종합정（myelodysplasticsymdromes，MDS）중골수CD34+세포CXCR4적표체정황급기여세포천이솔적상관성。방법：수집40례골수증생이상종합정환자적골수표본，근거IPSS적분계통진행위험도분조。저위조20례：IPSS적분0～1.5분；고위조20례：IPSS적분≥1.5분；동시채집10례건강자적골수표본작위대조。분리순화골수CD34+세포，통과류식세포술검측CXCR4막단백적표체；연구SDF-1α추화작용하CD34+세포적천이솔급CD34+세포대골수기질세포적천이솔。결과：고위조MDS환자CD34+세포CXCR4적표체솔명현고우저위조화정상대조조（P<0.0001）；저위조화정상대조조지간CXCR4적표체솔무현저성차이（P>0.05）。고위조CD34+세포대SDF-1α급골수기질세포적천이솔현저고우저위조급정상조（균P<0.0001），차기대골수기질세포적천이솔여CXCR4적표체정정상관（P=0.0001）。결론：고위조MDS환자CD34+세포CXCR4적표체량급기대골수기질세포적천이솔균명현고우저위조환자，차기천이솔수CXCR4표체량적증가이승고，불동풍험조적MDS환자존재SDF-1급기수체CXCR4표체화공능상적차이，SDF-1급기수체CXCR4재MDS발병중구유중요작용。
Objective:To evaluate the expression of CXCR4 and the migration rate of bone marrow stromal CD34+cells in differ-ent risk groups with myelodysplastic syndromes (MDS) using correlation analysis. Methods: Forty MDS patients were divided into low-and high-risk groups based on the International Prognosis Scoring System (IPSS). The former was composed of 20 patients with IPSS<1.5, whereas the latter was composed of 20 patients with IPSS≥1.5. Bone marrow (BM) samples of these patients and 10 nor-mal controls were collected. CD34+cells were separated and purified. The expression of CXCR4 was determined by flow cytometry. The migration rate of CD34+cells on the chemotactic effect of SDF-1αand on the effect of bone marrow stromal cells were measured. Results:The expression rate of CXCR4 was higher in the high-risk MDS group than in the low-risk and control groups (P<0.000 1). No significant differences existed between the low-risk and the control groups (P>0.05). The migration rate of CD34+cells on the ef-fects of SDF-1αand marrow stromal cells were significantly increased in the high-risk MDS group compared with those in the low-risk and control groups (P<0.000 1). Migration rate of CD34+cells on the effect of marrow stromal cells was positively correlated with CX-CR4 expression (P=0.000 1). Conclusion:The CXCR4 expression and migration rates of CD34+cells on the effect of marrow stromal cells are significantly higher in the high-risk MDS group than in the low-risk group. Migration rate has a positive correlation with the CXCR4 expression, which further indicates that MDS is a heterogeneous group of hematopoietic stem cell malignancies. The expres-sion and function of SDF-1 and its receptor CXCR4 differ within each group with various risks. SDF-1 and CXCR4 may be involved in MDS pathogenesis.