病态造血质与量在骨髓增生异常综合征诊断中的重要性

摘要

Objective To diagnose patients with myelodysplastic syndrome (MDS) according to the latest diagnostic criteria.Methods Peripheral blood and bone marrow smears of 150 cases with MDS were re-counted to analyze the quality and quantity of each department dyshaematopoiesis and all patients were diagnosed according to diagnostic criteria issued by World Health Organi-zation(WHO) in 2008.Results Among 150 patients with MDS, the subtypes included RCUD for 12 cases,including RA,RN and RT for 7,3 and 2 cases) ,RARS for 9 cases,RCMD for 30 cases, including 15 case with ring sideroblasts, RAEB- I for 51 cases, RAER- II for 36 cases and MDS-U for 12 cases.Conclusion Variegated clinical manifestations of MDS and lack of specific diagnostic methods might bring great pressure for laboratory diagnosis.The latest classification criteria supplemented the insufficiency of former criteria,and the category and quantity of dyshaematopoiesis in MDS were emphasized to prompt the study of MDS diagnosis, treatment and prognosis.%目的 参照最新的骨髓增生异常综合征(MDS)诊断标准对MDS患者进行实验室诊断.方法 将150例MDS患者外周血及骨髓涂片标本进行细胞计数,观察各系病态造血的质与量,依据世界卫生组织2008年颁布的诊断标准进行实验室诊断.结果 150例MDS患者中,单系病态造血的难治性血细胞减少症12例[难治性贫血(RA)7例、难治性中性粒细胞减少(RN)3例、难治性血小板减少(RT)2例],RA伴环形铁粒幼细胞9例；难治性血细胞减少伴多系病态造血30例(伴环形铁粒幼细胞15例)；RA伴原始细胞增多(RAEB)-I、Ⅱ分别为51、36例,MDS无法分类12例.结论 MDS临床表现多样化及诊断技术缺乏特异性给实验室诊断带来巨大压力；新版MDS诊断标准对旧版诊断标准的不足进行了补充,并着重强调病态造血质与量对MDS的诊断价值,推动了MDS诊断、治疗和预后判断的研究.