Department of Hematology Oncology, University of Pavia Medical School and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Cytometry B Clin Cytom. 2011 Jul-Aug;80(4):201-11. doi: 10.1002/cyto.b.20607. Epub 2011 Jun 14.
The pathological hallmark of myelodysplastic syndromes (MDS) is marrow dysplasia, which represents the basis of the WHO classification of these disorders. This classification provides clinicians with a useful tool for defining the different subtypes of MDS and determining individual prognosis. The WHO proposal has raised some concern regarding minimal diagnostic criteria particularly in patients with normal karyotype without robust morphological markers of dysplasia (such as ring sideroblasts or excess of blasts). Therefore, there is clearly a need to refine the accuracy to detect marrow dysplasia. Flow cytometry (FCM) immunophenotyping has been proposed as a tool to improve the evaluation of marrow dysplasia. Rationale for the application of FCM in the diagnostic work up of MDS is that immunophenotyping is an accurate method for quantitative and qualitative evaluation of hematopoietic cells and that MDS have been found to have abnormal expression of several cellular antigens. To become clinically applicable, FCM analysis should be based on parameters with sufficient specificity and sensitivity, data should be reproducible between different operators and the results should be easily understood by clinicians. In this report, we reviewed the most relevant progresses in detection of marrow dysplasia by FCM in MDS as defined by WHO criteria.
骨髓增生异常综合征（MDS）的病理标志是骨髓增生异常，这是世界卫生组织（WHO）这些疾病分类的基础。该分类为临床医生提供了一个有用的工具，用于定义 MDS 的不同亚型，并确定个体预后。WHO 的建议引起了人们对最小诊断标准的一些关注，特别是在没有明显形态学发育不良标志物（如环形铁幼粒细胞或过多的原始细胞）的正常核型患者中。因此，显然需要提高检测骨髓增生异常的准确性。流式细胞术（FCM）免疫表型分析已被提议作为一种提高骨髓增生异常评估的工具。在 MDS 的诊断工作中应用 FCM 的理由是，免疫表型分析是定量和定性评估造血细胞的准确方法，并且已经发现 MDS 存在几种细胞抗原的异常表达。为了具有临床适用性，FCM 分析应基于具有足够特异性和灵敏度的参数，数据应在不同操作人员之间具有可重复性，并且结果应易于临床医生理解。在本报告中，我们回顾了 WHO 标准定义的 MDS 中通过 FCM 检测骨髓增生异常的最相关进展。
