Wu Yu-Jie, Li Jian-Yong, Qiu Hai-Rong, Xiao Bing, Zhang Jian-Fu, Song Jun-Hong
Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2006 Feb;14(1):50-3.
This study was aimed at exploring the immunophenotypic features of blasts in patients with myelodysplastic syndromes (MDS). Four-color flow cytometry using conventional and secondary gating strategies was used to immunophenotype blasts and the CD34 positive cells in bone marrow nucleated cells of 29 patients with MDS. The results showed: (1) with progression of MDS from RA/RAS, RAEB to RAEB-T, the proportion of CD34(+) cells were gradually increased from 8.0%, 46.4% to 76.8% (P < 0.05); (2) using CD45 vs SSC gating strategy, with the transformation of RA/RAS, RAEB to RAEB-T, the expression of HLA-DR, CD13, CD33, CD117 were also gradually increased (P < 0.05), and the expression of CD15 was gradually decreased (P < 0.05); (3) using CD45 vs CD34 gating strategy, the expression of HLA-DR, CD13, CD33, CD117 on blasts were higher by secondary gating method than those by conventional gating (P < 0.05). However, there were no significant difference (P > 0.05) in the expression of above-mentioned antigens on CD34(+) cells among different MDS subtypes. It is concluded that conventional gating method can reflect MDS progression from RA/RAS, RAEB to RAEB-T, and secondary gating strategy may accurately reflect the biological features of blasts in MDS. Abnormal expression of CD34 is related to the immaturity level and heterogeneity of blast cells, which is beneficial to the diagnosis of clinically suspected MDS incapable of diagnosing with morphology and cytogenetics.
本研究旨在探索骨髓增生异常综合征（MDS）患者原始细胞的免疫表型特征。采用常规和二级设门策略的四色流式细胞术对29例MDS患者骨髓有核细胞中的原始细胞及CD34阳性细胞进行免疫表型分析。结果显示：（1）随着MDS从RA/RAS、RAEB进展至RAEB-T，CD34(+)细胞比例从8.0%、46.4%逐渐增至76.8%（P<0.05）；（2）采用CD45对SSC设门策略，随着RA/RAS、RAEB向RAEB-T转化，HLA-DR、CD13、CD33、CD117的表达也逐渐增加（P<0.05），而CD15的表达逐渐降低（P<0.05）；（3）采用CD45对CD34设门策略，二级设门法检测原始细胞上HLA-DR、CD13、CD33、CD117的表达高于常规设门法（P<0.05）。然而，不同MDS亚型中CD34(+)细胞上上述抗原的表达无显著差异（P>0.05）。结论是常规设门法可反映MDS从RA/RAS、RAEB至RAEB-T的进展，二级设门策略可能准确反映MDS中原始细胞的生物学特征。CD34的异常表达与原始细胞的不成熟水平和异质性有关，有助于对临床疑似但形态学和细胞遗传学无法诊断的MDS进行诊断。
