摘要【目的】探讨CD177+中性粒细胞在骨髓增生异常综合征(MDS)患者外周血中的比例及其临床意义。【方法】选择在本院连续治疗的MDS患者100例,按照MDS国际预后积分系统(IPSS)危险度将MDS患者分为低危组63例和高危组37例,按照贫血严重程度分为血红蛋白(Hb)正常组11例,轻度贫血组23例,中度贫血组42例,重度贫血组24例,另选择同期健康体检者50例作为对照组。采用流式细胞术检测CD177+在中性粒细胞中表达情况,采用Kaplan-Meier法分析CD177+中性粒细胞比例与MDS患者预后的关系,Cox回归模型分析MDS患者预后的影响因素。【结果】MDS患者外周血中CD177+中性粒细胞水平明显高于正常对照组(P<0.05);与Hb正常组比较,中度贫血组、重度贫血组MDS患者CD177+中性粒细胞水平显著升高(P<0.05),轻度贫血组CD177+中性粒细胞水平无明显变化(P>0.05),轻度贫血组、中度贫血组、重度贫血组MDS患者CD177+中性粒细胞水平依次升高,且差异有统计学意义(P<0.05);CD177+中性粒细胞水平与Hb、血小板、染色体、IPSS危险度分类有关(P<0.05);CD177+中性粒细胞高水平组患者3年累积生存率显著低于低水平组(35.11% vs 53.93%,P<0.05);染色体异常、CD177+中性粒细胞高水平是影响MDS患者不良预后独立危险因素(P<0.05)。【结论】MDS患者外周血中CD177+中性粒细胞水平明显增高,是影响患者预后的独立危险因素。
Abstract：【Objective】 To detect the proportion of CD177+ neutrophils in patients with myelodysplastic syndrome (MDS) and explore its clinical significance. 【Methods】 A total of 100 MDS patients who were treated continuously in the Hematology Department of our hospital were selected. According to the MDS International Prognostic Scoring System (IPSS) risk, MDS patients were divided into the low-risk cases (n=63) and the high-risk cases (n=37).Furthermore, according to the severity of anemia, they were divided into normal hemoglobin (Hb) group (n=11), mild anemia group (n=23), moderate anemia group (n=42) and severe anemia group (n=24).In addition, 50 healthy vounteers who underwent physical examination during the same period were selected as the control group. The expression of CD177+ in neutrophils was detected by flow cytometry. Kaplan Meier method was used to analyze the relationship between the proportion of CD177+ neutrophils and the prognosis of MDS patients. Cox regression model was used to analyze the prognostic factors of MDS patients. 【Results】 The level of CD177+ neutrophils in the peripheral blood of MDS patients was significantly higher than that of the normal control group (P<0.05).Compared to those with normal hemoglobin, the levels of CD177+ neutrophils in MDS patients of moderate anemia group and severe anemia group were significantly increased (P<0.05), while there was no significant difference in the level of CD177+ neutrophils between MDS patients of mild anemia group and normal hemoglobin group (P>0.05). The levels of CD177+ neutrophils in MDS patients in mild anemia group, moderate anemia group and severe anemia group were increased in turn, and the differences were statistically significant (P<0.05). The level of CD177+ neutrophils was also related to the hemoglobin, platelet, chromosome and risk classification of IPSS (P<0.05). The 3 years cumulative survival rate of patients with myelodysplastic syndrome in the high CD177+ neutrophil level group was significantly lower than that in the low level group (35.11% vs 53.93%, P<0.05). Chromosomal abnormality and high level of CD177+ neutrophils were independent risk factors for poor prognosis of MDS (P<0.05). 【Conclusion】 The level of CD177+ neutrophils in the peripheral blood of MDS patients significantly increased, which is an independent risk factor for the prognosis of MDS patients
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2022, Vol. 39 
