骨髓增生异常综合征染色体核型与病态造血和网硬蛋白的相关性研究

摘要

This study was purposed to explore the correlation of chromosome karyotype with dyshaematopoiesis and reticulin in myelodysplastic syndrome (MDS). The data of 202 MDS patients diagnosed and treated in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed in term of chromosome karyotype, dyshaematopoiesis and reticulin detection results. The chromosome karyotypes were categorized according to the International Prognostic Scoring System( IPSS). The results showed that there was a positive correlation between chromosome karyotype grading and number of lineages with dyshaematopoiesis ( r - 0. 443, P < 0. 05 ). The detected rates of multilineage dyshaematopoiesis in patients with good, intermediate and poor chromosome karyotypes were 44.4% ,71.4% and 96. 3% respectively. There was a positive correlation between chromosome karyotype grading and reticulin grading (r = 0. 451,P < 0. 05). The positive rates of reticulin in patients with good grading, intermediate and poor chromosome karyotypes were 36. 8% ,64. 3% and 92.6% respectively. The detected rate of multilineage dyshaematopoiesis, number of lineages with dyshaematopoiesis, the positive rate of reticulin and reticulin grade in patients with poor karyotypes were higher than those in patients with intermediate or good chromosome karyotypes (seperately P <0.01). The above data in patients with intermediate chromosome karyotypes were higher than those in patients with good chromosome karyotypes (seperately P <0.01). It is concluded that the chromosome karyotype grading positively correlates with the number of lineages with dyshaematopoiesis and reticulin grading. When the chromosome karyotype changed from good to poor, the detected rate of multilineage dyshaematopoiesis, number of lineages with dyshaematopoiesis, positive rate of reticulin and reticulin grading became higher and higher.%本研究旨在探讨骨髓增生异常综合征(MDS)染色体核型与病态造血及网硬蛋白的相关性.回顾性分析了我院就诊的202例MDS患者的染色体核型、病态造血和网硬蛋白检查结果.染色体核型按国际预后积分系统(IPSS)进行分级.结果表明:染色体核型预后级别与病态造血累及系统数呈正相关(r=0.443,P＜0.05).预后好、中、差核型组患者的多系病态造血检出率分别为44.4％,71.4％,96.3％.染色体核型预后级别与网硬蛋白级别呈正相关(r =0.451,P＜0.05).预后好、中、差核型组患者的网硬蛋白阳性率分别为36.8％,64.3％,92.6％.比较三种核型组患者的多系病态造血检出率、病态造血累及系统数、网硬蛋白阳性率和网硬蛋白级别,发现预后差核型组明显高于预后中等和预后好核型组(P均＜0.01),预后中等核型组明显高于预后好核型组(P均＜0.01).结论:染色体核型预后级别与病态造血累及系统数和网硬蛋白级别均呈正相关,随着染色体核型预后由好到差,多系病态造血检出率、病态造血累及系统数、网硬蛋白阳性率和网硬蛋白级别均增高.