Guvendir Bakkaloglu Irem, Zemheri Itir Ebru, Kaya Ali Hakan, Kilicaslan Emrah
Pathology Department, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul 34865, Turkey.
Pathology Department, Umraniye Training and Research Hospital, Health Sciences University, Istanbul 34668, Turkey.
Diagnostics (Basel). 2024 Dec 3;14(23):2720. doi: 10.3390/diagnostics14232720.
A detailed examination of bone marrow (BM) aspiration and biopsy can provide clues regarding the course of the disease as well as the diagnostic features of myelodysplastic syndrome (MDS).
Our aim is to reveal the histomorphological features of MDS, investigate the impact of dysplasia types on prognosis, and highlight the importance of the microenvironment.
In 130 (93.5%) of 139 cases, Wright-Giemsa-stained BM aspiration slides were evaluated, and the dysplasia diversity was examined in detail. A regression analysis of dysplasia features significant for overall survival revealed that the presence of hyperlobulation in the megakaryocytic series ( = 0.014, odds ratio = 3.485) and the presence of an abnormal localization of immature progenitors (ALIP) ( = 0.010, odds ratio = 2.206) were significantly associated with poor prognosis. Additionally, an increase in the microvessel density (MVD) was found to be associated with a poor prognosis ( < 0.001). A multiple regression analysis identified that MVD is the most significant parameter ( = 0.014).
The diversity of dysplasia in BM aspiration and biopsy does not predict MDS subtypes; however, certain cytomorphological dysplasia types can provide insights regarding survival. The microenvironment's impact on MDS pathogenesis is undeniable, with ALIP and MVD presence and frequency being significant factors. Thus, BM histomorphological examination, beyond its diagnostic role, also offers prognostic insights.
对骨髓穿刺和活检进行详细检查可提供有关疾病进程以及骨髓增生异常综合征（MDS）诊断特征的线索。
我们的目的是揭示MDS的组织形态学特征，研究发育异常类型对预后的影响，并强调微环境的重要性。
在139例病例中的130例（93.5%）中，对瑞氏-吉姆萨染色的骨髓穿刺涂片进行了评估，并详细检查了发育异常的多样性。对总生存有显著意义的发育异常特征的回归分析显示，巨核细胞系列中出现多分叶（P = 0.014，比值比 = 3.485）以及未成熟祖细胞异常定位（ALIP）的存在（P = 0.010，比值比 = 2.206）与预后不良显著相关。此外，发现微血管密度（MVD）增加与预后不良相关（P < 0.001）。多元回归分析确定MVD是最显著的参数（P = 0.014）。
骨髓穿刺和活检中发育异常的多样性不能预测MDS亚型；然而，某些细胞形态学发育异常类型可提供有关生存的见解。微环境对MDS发病机制的影响不可否认，ALIP和MVD的存在及频率是重要因素。因此，骨髓组织形态学检查除了其诊断作用外，还提供预后见解。
