Matsuda Akira
Department of Hemato-Oncology, Saitama International Medical Center, Saitama Medical University.
Rinsho Ketsueki. 2017;58(4):336-346. doi: 10.11406/rinketsu.58.336.
Although cytomorphologic evaluation is important for the diagnosis of myelodysplastic syndromes (MDS), a standardized approach is still lacking. According to the World Health Organization classification, the minimum percentage of cells manifesting dysplasia required to qualify as significant is ≥10% in one or more hematopoietic cell lineages. However, the suitability of this threshold (10%) has not been fully assessed in each lineage. Definitions of the various dysplastic forms that are important for the diagnosis of MDS are still lacking. Morphologic definitions of dysplastic forms have been proposed by the International Working Group on Morphology of MDS (IWGM-MDS). For the diagnosis of MDS, morphologic dysplastic changes should be classified into two categories: those with highly specific forms and those with less specific forms. Quantitative morphologic evaluations that include the specificity of the dysplastic forms have been reported by the "National Research Group on Idiopathic Bone Marrow Failure Syndromes, Japan" and "Rete Ematologica Lombarda (REL) clinical network."
虽然细胞形态学评估对于骨髓增生异常综合征(MDS)的诊断很重要,但仍缺乏标准化方法。根据世界卫生组织的分类,在一个或多个造血细胞谱系中,有发育异常表现的细胞达到≥10%才能被认定为有意义。然而,这一门槛(10%)在各谱系中的适用性尚未得到充分评估。对于MDS诊断至关重要的各种发育异常形式的定义仍不明确。MDS形态学国际工作组(IWGM-MDS)已经提出了发育异常形式的形态学定义。对于MDS的诊断,形态学发育异常变化应分为两类:具有高度特异性形式的和特异性较低形式的。“日本特发性骨髓衰竭综合征国家研究小组”和“伦巴第血液学网络(REL)临床网络”报告了包括发育异常形式特异性的定量形态学评估。