目的了解骨髓增生异常综合征(MDS)患者外周血细胞免疫表型特征。方法采用多色流式细胞术CD45/SSC双参数散点图设门方法，对38例MDS组患者及24例Non-MDS组患者外周血原始细胞群、粒细胞群及单核细胞群免疫表型进行分析。结果MDS组患者外周血原始细胞群、粒细胞群及单核细胞群均存在异常免疫表型。MDS组和Non-MDS组外周血原始细胞群中CD34+细胞聚集的患者为16例和3例，比例分别占42.1%和12.5%，差异有统计学意义(P＜0.05)。两组中，外周血原始细胞群表达CD11b+细胞的患者为10例(26.3%)和1例(2.6%)。MDS组高于Non-MDS组，差异有统计学意义(P＜0.05)。MDS组粒细胞群中侧向散射光(SSC)的平均荧光强度和CD10的几何平均荧光强度(G-MFI)分别为7.4±2.8，4.0±3.4;Non-MDS组分别为9.5±2.7，8.2±6.6，MDS组均明显低于Non-MDS组，差异有统计学意义(P＜0.01)。结论MDS患者外周血细胞上存在异常的免疫表型，其特点有助于MDS与Non-MDS疾病的鉴别。
Objective To investigate the characteristics of immunophenotype in patients with myelodysplastic syndrome (MDS) using the samples of peripheral blood (PB). Methods The antigen expression of myeloblasts, granulocytes and monocytes in samples of peripheral blood from 38 patients with MDS and 24 patients with Non-MDS were detected by multicolor flow cytometry with four color and CD45/SSC gating. Results The abnormal immunophenotypes were existed in myeloblasts, granulocytes and monocytes in samples of PB from MDS group. The results were showed that 16 patients (42.1%) have clustered distribution of CD34+ cells on PB myeloblasts in MDS group and 3 patients (12.5%) in Non-MDS group (P＜0.05). The abnormal expression of CD11b+ cells on PB myeloblasts in MDS group (26.3%) was higher than that of in Non-MDS group (2.6%) (P＜0.05). The numbers of SSC and the Geometric mean fluorescent intensity (G-MFI) for CD10 on granulocytes in MDS group (7.4±2.8, 4.0±3.4) were significantly lower than that of in Non-MDS (9.5±2.7, 8.2±6.6) (P＜0.01) respectively. Conclusioren The abnormal Immunophenotypes can be found in patients with MDS using PB. It may be helpful to distinguish MDS from Non-MDS.
[1] Cherian S, Moore J, Bantly A, et al. Peripheral blood MDS score: a new flow cytometric tool for the diagnosis of myelodysplastic syndromes[J]. Cytometry B Clin Cytom,2005,64: 9-17.
[2] Rashidi H H, Xu X, Wang H Y, et al. Utility of peripheral blood flow cytometry in differentiating low grade versus high grade myelodysplastic syndromes (MDS) and in the evaluation of cytopenias[J]. Int J Clin Exp Pathol,2012,5(3): 224-230.
[3] Vardiman J W, Thiele J, Arber D A, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes[J]. Blood, 2009, 114(5): 937-951.
[4] Malcovati L, Della Porta M G, Lunghi M, et al. Flow cytometry evaluation of erythroid and myeloid dysplasia in patients with myelodysplastic syndrome[J]. Leukemia, 2005, 19(5): 776-783.
[5] Wells D A, Benesch M, Loken M R, et al. Myeloid and monocytic dyspoiesis as determined by flow cytometric scoring inmyelodysplastic syndrome correlates with the IPSS and with outcome after hematopoietic stem cell transplantation[J]. Blood, 2003, 102: 394-403.
[6] 郭轶先, 孙雪静, 路继莲, 等. 87例骨髓增生异常综合征多参数流式细胞术免疫表型分析[J]. 内科急危重症杂志, 2009, 15(5): 241-244.
[7] Xu D, Schultz C, Akker Y, et al. Evidence for expression of early myeloid antigens in mature, non-blast myeloid cells in myelodysplasia[J]. Am J Hematol, 2003, 74(1): 9-16.
[8] Cutrona G, Tasso P, Dono M, et al. CD10 is a marker for cycling cells with propensity to apoptosis inchildhood ALL[J]. Br J Cancer,2002,86: 1776-1785.
[9] Mohadese Hashem B, Rajesh R, Sabariah M N, et al. Qualitative flow cytometric analysis of Malaysian myelodysplastic syndromes (MDS) patients[J]. Med J Malaysia, 2012, 67(1): 77-80.
[10] Xue L F, Yang B, Zhou J, et al. The value of flow cytometry for the differential diagnosis between refractory cytopenia with multiple dysplasia and aplastic anemia[J]. Zhonghua Nei Ke Za Zhi, 2010, 49(6): 508-511.
[11] Huang M, Li J, Zhao G, et al. Immunophenotype of myeloid granulocytes: a pilot study for distinguishing myelodysplastic syndrome and aplastic anemia by flow cytometry[J]. Int J Lab Hematol, 2010, 32(3): 275-281.
[12] Chang C C, Cleveland R P. Decreased CD10- positive mature granulocytes in bone marrow from patients with myelodysplastic syndrome[J]. Arch Pathol Lab Med,2000,124: 1152-1156.
