急性髓系白血病骨髓纤维增生与预后的相关性分析

摘要

目的:定量分析骨髓纤维组织增生强度,探讨其与成人急性髓系白血病(AML)患者预后的相关性.方法:通过定量分析骨髓纤维组织增生强度,运用计算机网格记点法定量对比39例初发AML患者及35例正常骨髓切片中网硬蛋白纤维强度(reticulin fiber density,RFD),分析其对AML预后评估作用.结果:初发AML患者骨髓RFD为2.41％±0.23％,明显高于正常对照组1.14％±0.06％ (P ＜0.05),其中RFD＞ 1.68％的患者的无复发生存期(RFS)明显短于RFD≤1.68％者(P＜0.05);初发RFD＞ 2.66％的患者总生存期(OS)明显短于RFD≤2.66％的患者(P＜0.05).此外,初发AML患者骨髓RFD值和对应骨髓原始细胞计数(BM blast count)及外周血白细胞计数(WBC counts)之间相关系数r分别为0.01及0.04,均无统计学差异.结论:初发AML患者骨髓中异常增生的纤维组织是其预后不良的高危因素.%Objective:To investigate the correlation between the bone marrow fibrous proliferation and the prognosis of acute myeloid leukemia (AML).Methods:The quantitative method was used to analyze the reticulin fiber density (RFD) of AML patients.the bone marrow sections from 39 primary AML patients and 35 normal controls were collected to compare the RFD between these 2 groups.The prognosis value of RFD for AML were estimated by using appropriate statistical analysis.Results:RFD in primary AML was significantly higher than that in normal controls (2.41％ ±0.23％ vs 1.14％ ±0.06％) (P ＜0.05).Relapse-free survival(RFS) analysis showed that the patients with RFD more than 1.68％ indicated poor RFS,and the overall survival(OS) analysis showed that patients with RFD more than 2.66％ indicated poor overall survival (P ＜ 0.05).Besides,there were no relationship between RFD and the BM blast count (r =0.01) and WBC counts (r =0.04) at diagnosis(P ＞0.05).Conclusion:The RFD in bone marrow is a high risk factor in poor prognosis of AML patients.