文章摘要
梁 艳,沈文怡,张建富,王 蓉,李建勇,张苏江,陆 化.慢性粒-单核细胞白血病骨髓活检病理学分析[J].南京医科大学学报,2015,(12):1735~1738
慢性粒-单核细胞白血病骨髓活检病理学分析
Analysis of bone marrow biopsy pathology in chronic myelomonocytic leukemia
投稿时间:2015-10-08  
DOI:10.7655/NYDXBNS20151214
中文关键词: 慢性粒-单核细胞白血病  骨髓活检  免疫组化
英文关键词: chronic myelomonocytic leukemia  bone marrow biopsy  immunohistochemistry
基金项目:江苏省卫生厅指导性科研项目(Z201402);国家自然科学基金青年基金(81400079)
作者单位
梁 艳 南京医科大学第一附属医院血液科,江苏 南京 210029 
沈文怡 南京医科大学第一附属医院血液科,江苏 南京 210029 
张建富 南京医科大学第一附属医院血液科,江苏 南京 210029 
王 蓉 南京医科大学第一附属医院血液科,江苏 南京 210029 
李建勇 南京医科大学第一附属医院血液科,江苏 南京 210029 
张苏江 上海交通大学附属瑞金医院北院血液科,上海 200000 
陆 化 南京医科大学第一附属医院血液科,江苏 南京 210029 
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中文摘要:
      目的:分析慢性粒-单核细胞白血病(chronic myelomonocytic leukemia,CMML)的细胞形态学特点,为对照,探索免疫标记物在CMML诊断中的意义及临床应用价值。方法:采用骨髓活检病理组织学方法分析39例CMML的病理学特点;采用免疫组化法,以CMML为实验组,慢性粒细胞白血病(chronic myelocytic leukemia,CML)及急性单核细胞白血病(acute monocytic leukemia,AMoL)为对照组,检测CD15?MPO?CD34?CD14?CD56?CD68(PG-M1)?CD163在上述3组中的表达。结果:CMML骨髓病理组织学提示33例(84.6%)骨髓增生极度活跃,粒系细胞增生明显且形态异常,29例(74.4%)单核细胞增多,20例(51.3%)巨核细胞形态异常。粒细胞标记物CD15?MPO在CMML中的阳性表达率分别为(21.69 ± 7.06)%,(33.96 ± 5.94)%,其与CML及AMoL均有统计学差异。单核细胞标记物CD14?CD56?CD68(PG-M1)及CD163的阳性表达率分别为(10.10 ± 2.51)%?(8.69 ± 2.66)%?(13.35 ± 4.32)%?(11.43 ± 4.15)%,除CD56外,其余在CMML与AMoL的阳性率均有明显差异。原始细胞标记物CD34的阳性表达率为4.31±1.98%,与CML有统计学差异。结论:骨髓病理组织学及免疫组化有助于CMML的诊断及鉴别诊断。
英文摘要:
      Objective:To analysis the cell morphological characteristics in chronic myelomonocytic leukemia (CMML),and investigate the expression of immune marker in the diagnose and clinical application value of CMML. Methods:Using the bone marrow biospy pathology to analysis the pathology characteristics in 39 cases of CMML. By using the immunohistochemistry to detect the expression of antibodies which included CD15,MPO,CD34,CD14,CD56,CD68 (PG-M1)and CD163 in CMML,comparison with chronic myelocytic leukemia (CML) and the acute monocytic leukemia (AMoL) patients. Results:Hypercellularity was the markedly feature of the bone marrow histology in 33 cases (84.6%)of CMML. Increased granulocytic proliferation and obviously morphological abnormalities were observed in these cases. Monocytic cells were increased in 29 cases (74.4%)and 20 cases(51.3%)presented megakaryocytic morphological abnormalities. The marker in the granulocytic lineage expresses CD15 and MPO,which had respectively positive percentage of 21.69 ± 7.06% and 33.96 ± 5.94%,there were significantly statistical differences compared with CML and AMoL. The marker in the monocytes expresses CD14?CD56?CD68(PG-M1)and CD163,which were positive (10.10 ± 2.51)%?(8.69 ± 2.66)%?(13.35 ± 4.32)%?(11.43 ± 4.15)%,respectively. Except from CD56 positive CMML and AMoL,the rest had significantly statistical differences. The original marker which was positive expressed in CMML such as CD34 had the percentage of (4.31 ± 1.98)%,which had significantly statistical differences with CML. Conclusion:Morphological and immunohistochemical features of bone marrow biopsy are helpful in the diagnosis and differentiation.
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