常见骨髓增殖性肿瘤粒系CD33阳性指数的变化

doi:10.3969/j.issn.1673-8640.2019.09.004

摘要/Abstract

摘要：

目的探讨骨髓增殖性肿瘤（MPN）流式细胞免疫表型粒系CD33阳性指数的变化。方法采用流式细胞免疫表型分析,对95例MPN患者[慢性髓系白血病（CML）42例、原发性血小板增多症（ET）29例、真性红细胞增多症（PV）13例、原发性骨髓纤维化（PMF）11例]粒系CD33阳性指数的表达进行分析。另选取30例单纯性缺铁性贫血患者作为对照组。结果 CML组、ET组、PV组、PMF组的CD33阳性指数分别为26.35±13.40、5.44±3.72、5.44±2.83、1.54±1.25,与对照组（9.62±5.07）相比差异均有统计学意义（P<0.01）。结论粒系CD33阳性指数在CML、ET+PV、PMF中依次降低,可作为MPN诊断的一个新型流式细胞免疫表型分析指标。

关键词: CD33阳性指数, 骨髓增殖性肿瘤, 流式细胞术

Abstract:

Objective To investigate the change of granulocyte CD33 index in common myeloproliferative neoplasms（MPN） by flow cytometry. Mehods A total of 95 MPN patients,including 42 cases of chronic myeloid leukaemia（CML）,29 cases of essential thrombocytosis（ET）,13 cases of polycythemia vera（PV） and 11 cases of primary myelofibrosis（PMF）,were determined for granulocyte CD33 index by flow cytometry. A total of 30 patients with iron deficiency anemia were enrolled as control group. Results Granulocyte CD33 indexes of CML,ET,PV and PMF groups were 26.35±13.40,5.44±3.72,5.44±2.83 and 1.54±1.25,respectively,which had statistical significance compared to that of control group（9.62±5.07）（P<0.01）. Conclusions Granulocyte CD33 index of CML group is the highest,followed by ET+PV and PMF groups. Granulocyte CD33 index can be a new abnormal immunophenotype for the diagnosis of MPN.

Key words: CD33 index, Myeloproliferative neoplasm, Flow cytometry

中图分类号:

R446.1

殷仁斌, 丁利霞, 任伟丹, 刘玉霞, 张鹏, 陈辉树, 岳保红. 常见骨髓增殖性肿瘤粒系CD33阳性指数的变化[J]. 检验医学, 2019, 34(9): 787-791.

YIN Renbin, DING Lixia, REN Weidan, LIU Yuxia, ZHANG Peng, CHEN Huishu, YUE Baohong. Change of granulocyte CD33 index in common myeloproliferative neoplasms[J]. Laboratory Medicine, 2019, 34(9): 787-791.

图/表 3

图1 CD33阳性表达设门（分析目的细胞群）策略注：（a）CD45-Neg为CD45阴性区,CD45 Dim为CD45弱阳性区,Baso为嗜碱性粒细胞,Granulocytic series为粒系细胞,Monocytes为单核细胞,Lymphocyte为淋巴细胞;（b）淋巴细胞CD33 MFI为1.02;（c）粒系细胞CD33 MFI为65.90;（d）单核细胞CD33 MFI为161.22

表1 53例Ph染色体阴性MPN患者临床资料

组别	例数	年龄（岁）	男∶女	染色体异常（例）	髓系原始细胞比例（流式CD34+CD117+细胞比例）（%）	JAK2-V617F基因突变[例（%）]	CALR基因突变[例（%）]	MPL-W515基因突变[例（%）]
ET组	29	62（21~78）	1.50∶1	2	0.467±0.300	22（76）	6（21）	1（3）
PV组	13	63（46~72）	0.44∶1	0	0.347±0.207	13（100）	0（0）	0（0）
PMF组	11	62（49~74）	1.20∶1	4	0.929±0.948	5 （45）	1（9）	0（0）

图2 MPN粒系CD33荧光强度注：CD45-Neg为CD45阴性区,CD45 Dim为CD45弱阳性性,Baso为嗜碱性粒细胞,Granulocytic Series为粒系细胞,Monocytes为单核细胞,Lymphocyte为淋巴细胞;（a）、（b）、（c）、（d）分别为CML组、ET组、PV组、PMF组CD45 SS散点图;（e）、（f）、（g）、（h）分别为CML组、ET组、PV组、PMF组HLA-DR CD33散点图,可见CML组、ET组、PV组、PMF组粒系CD33荧光强度依次减弱

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