Kai Yang, Yuanyuan Dai, Shihe Guan, Xuanxuan Mu, Hao Zhang, Ying Pan, Yuanyuan Wu, Aihua Wang, Beibei Sun, Tingdong Zhou
Clin Lab. 2016 Sep 1;62(9):1767-1772. doi: 10.7754/Clin.Lab.2016.160211.
Aplastic anemia (AA), paroxysmal nocturnal hemoglobinuria (PNH), and myelodysplastic syndrome (MDS) are the common spectrums of acquired bone marrow failure syndromes (BMFs). Accurate and timely diagnosis is a significant clinical challenge because of the overlapping features. The pathogenesis is not fully understood, but several studies have suggested that defective monocyte functions play an important role. We aimed to find whether the different expressions of CD52, CD14 and HLA-DR on CD4+ monocytes would be helpful in the preliminary diagnosis of acquired BMFs.
This study included 45 patients (21 AA patients, 13 MDS patients, 11 PNH patients). The control group was composed of 33 healthy adults. Flow cytometry was performed to determine the fluorochrome conjugated antibodies, including CD52, CD14 and HLA-DR.
In this study, we found the expression of CD52 on CD4+ monocytes in AA patients was significant lower than MDS [15.90% (2.39 - 25.70) vs. 60.63% (26.0 - 94.98), p < 0.001] and healthy controls [15.90% (2.39 - 25.70) vs. 67.19% (25.5 - 88.4)%, p < 0.001], and a little higher than PNH patients [15.90% (2.39 - 25.70) vs. 4.55% (3.1 - 6.0), p < 0.05]. While comparing the levels of HLA-DR on CD4+ monocytes, AA patients were lower than PNH [40.05% (17.2 - 73.3) vs. 83.14% (80.7 - 94.3), p < 0.001] and MDS patients [40.05% (17.2 - 73.3) vs. 82.37% (69.1 - 91.2), p < 0.001].
According to our knowledge, this is a new clinical diagnostic method that uses surface markers for CD4+ monocytes such as CD52, CD14, and HLA-DR to make differential diagnoses within AA, PNH, and MDS patients in clinical practice. In addition, CD52 in patients shows that CD52 represents the most valuable molecular marker for differential diagnosis of three types of acquired BMFs.
再生障碍性贫血（AA）、阵发性睡眠性血红蛋白尿（PNH）和骨髓增生异常综合征（MDS）是获得性骨髓衰竭综合征（BMF）的常见类型。由于其特征重叠，准确及时的诊断是一项重大的临床挑战。其发病机制尚未完全明确，但多项研究表明单核细胞功能缺陷起重要作用。我们旨在探讨CD4⁺单核细胞上CD52、CD14和HLA - DR的不同表达是否有助于获得性BMF的初步诊断。
本研究纳入45例患者（21例AA患者、13例MDS患者、11例PNH患者）。对照组由33名健康成年人组成。采用流式细胞术检测荧光素偶联抗体，包括CD52、CD14和HLA - DR。
在本研究中，我们发现AA患者CD4⁺单核细胞上CD52的表达显著低于MDS患者[15.90%（2.39 - 25.70）对60.63%（26.0 - 94.98），p < 0.001]和健康对照组[15.90%（2.39 - 25.70）对67.19%（25.5 - 88.4）%，p < 0.001]，且略高于PNH患者[15.90%（2.39 - 25.70）对4.55%（3.1 - 6.0），p < 0.05]。比较CD4⁺单核细胞上HLA - DR水平时，AA患者低于PNH患者[40.05%（17.2 - 73.3）对83.14%（80.7 - 94.3），p < 0.001]和MDS患者[40.05%（17.2 - 73.3）对82.37%（69.1 - 91.2），p < 0.001]。
据我们所知，这是一种新的临床诊断方法，在临床实践中利用CD4⁺单核细胞的表面标志物如CD52、CD14和HLA - DR对AA、PNH和MDS患者进行鉴别诊断。此外，患者中的CD52表明CD52是三种获得性BMF鉴别诊断中最有价值的分子标志物。
