1] Service d'Hématologie Biologique, Hôpitaux Universitaires Paris Centre-Cochin, Paris, France [2] Inserm U1016, UMR 8104, Université Paris Descartes, Hôpitaux Universitaires Paris Centre-Cochin, Paris, France.
Leukemia. 2013 Oct;27(10):1981-7. doi: 10.1038/leu.2013.178. Epub 2013 Jun 14.
Several groups have published flow cytometry scores useful for the diagnosis or prognosis of myelodysplastic syndromes (MDS), mainly based on the detection of immunophenotypic abnormalities in the maturation of granulocytic/monocytic and lymphoid lineages. As anemia is the most frequent symptom of early MDS, the aim of this study was to identify markers of dyserythropoiesis relevant for the diagnosis of MDS analyzed by selecting erythroblasts in a whole no-lysis bone marrow strategy by using a nuclear dye. This prospective study included 163 patients, including 126 with cytopenias leading to MDS suspicion and 46 controls without MDS. In a learning cohort of 53 unequivocal MDS with specific markers, there was a significant difference between the coefficients of variation of mean fluorescence intensities of CD71 and CD36 in MDS patients compared with controls. These two parameters and the hemoglobin level were used to build a RED-score strongly suggestive of MDS if ≥ 3. Using the RED-score in the whole cohort, 80% of MDS or non-MDS patients were correctly classified. When combined with the flow score described by Ogata et al., this strategy allowed to reach a very high sensitivity of 88% of patients correctly classified.
已有多个小组发表了流式细胞术评分，这些评分可用于诊断或预测骨髓增生异常综合征（MDS），主要基于对粒细胞/单核细胞和淋巴系成熟过程中免疫表型异常的检测。由于贫血是早期 MDS 最常见的症状，因此本研究旨在通过使用核染料选择全裂解骨髓策略中的有核红细胞来鉴定与 MDS 诊断相关的红细胞生成异常标志物。这项前瞻性研究纳入了 163 名患者，包括 126 名因血细胞减少而怀疑 MDS 的患者和 46 名无 MDS 的对照者。在一个具有特定标志物的 53 例明确 MDS 的学习队列中，MDS 患者与对照组相比，CD71 和 CD36 的平均荧光强度的变异系数有显著差异。如果这两个参数和血红蛋白水平的 RED 评分≥3，则强烈提示 MDS。在整个队列中使用 RED 评分，80%的 MDS 或非 MDS 患者被正确分类。当与 Ogata 等人描述的流式评分结合使用时，这种策略可以达到 88%的患者被正确分类的高灵敏度。
