【摘要】 为了观察骨髓增生异常综合征 (MDS)患者骨髓CD34+ 细胞Fas ,FasL和Bcl 2的表达和凋亡情况并探讨这些抗原的表达和细胞凋亡的关系。采用流式细胞术测定了 2 6例MDS和 10例急性髓系白血病 (AML)患者及 6例非血液病患者 (对照 )骨髓CD34+ 细胞的Fas,FasL和Bcl 2表达率和细胞凋亡率。结果显示 ,各型MDS患者CD34+ 细胞Fas和FasL表达率较对照组明显增加 (P <0 .0 1) ,Bcl 2的表达率除难治性贫血 /环形铁粒幼细胞性难治性贫血 (RA/RAS)与对照组无显著差异 (P >0 .0 5 )外 ,难治性贫血伴有原始细胞增多 (RAEB)和转变中的难治性贫血伴原始细胞增多 (RAEB t)患者均明显高于对照组 (P <0 .0 1) ;各型MDS间CD34+ 细胞Fas的表达率相近 ,而Bcl 2的表达率却存在非常显著性差异 ,即RA/RAS <RAEB <RAEB t;RA/RAS和RAEB患者CD34+ 细胞的凋亡率显著高于对照组 ,而RAEB t患者与对照组间无显著差异 ,AML患者则明显低于对照组 ;CD34+ 细胞Fas或FasL的表达率与凋亡率间无相关关系 ,而Bcl 2表达率和细胞凋亡率间存在负的相关关系。结论 :MDS患者CD34+ 细胞的凋亡受多因素的调节 ;Bcl 2是抑制细胞凋亡的重要因素 ;MDS向AML进展过程中CD34+ 细胞存在从凋亡过度到凋亡减少的改变更多还原

【Abstract】 In order to observe the expression of Fas, FasL and Bcl 2 and apoptosis of bone marrow CD34 + cells in patients with myelodysplastic syndrome (MDS), and to explore the relation between the expression of these antigens and apoptosis, the expression of Fas, FasL and Bcl 2 and apoptosis of bone marrow CD34 + cell were evaluated by flow cytometry in 26 patients with MDS including 9 cases of refactory anemia (RA), 1 case of RA with ringed sideroblasts(RAS), 9 cases of RA with excess blasts(RAEB) and 7 cases of RAEB in transformation (RAEB t), 10 patients with acute myeloid leukemia (AML) and 6 control patients with normal bone marrow. The results showed that the expression of Fas and FasL of CD34 + cells significantly increased in all types of MDS patients compared with control group (P<0 01). The expression of Bcl 2 on CD34 + cells in RAEB and RAEB t patients was much higher as compared with that in control group (P<0.01), but there was no significant difference between RA/RAS patients and control group (P>0 05). The expression rates of Fas on CD34 + cells were almost identical in all kinds of MDS, but there was significant difference on the expression of Bcl 2 (RA/RAS< RAEB<RAEB t). Apoptosis of CD34 + cells significantly increased in RA/RAS and RAEB patients compared with control group (P<0.01), but there was no difference between RAEB t and control group. Moreover, apoptosis of CD34 + cells in control much higher than that in AML group (P<0 01). There was no correlation between the expression of Fas or FasL and apoptosis on CD34 + cell of MDS patients. Nevertheless, there was a negative correlation between the expression of Bcl 2 and apoptosis. It is concluded that apoptosis of CD34 + cells was affected by a lot of factors in MDS, in which Bcl 2 is an important factor of depressing apoptosis. During the progress from MDS to AML, apoptosis changes from overgoing to deficiency in CD34 + cell.更多还原