The Significance Of Quantitative Analysis Of Dysplasia In The Diagnosis And Prognosis Of MDS

Objective: This survey is aimed to take count of the type and quantity of dysplasia in myelodysplastic syndrome (MDS),and conclude the regular clues of morphologic diagnosis to improve accuracy of its diagnosis. Besides, whether the type and quantity of dysplasia having meaning to the diagnosis, classification, treatment and prognosis of MDS is also the concern of this survey.Methods: According to the clinical documents and laboratory results of 145 patients who havesuffered the Hematologic diseases including RA, RARS, RCMD, RAEB, RAEBⅡand 5q-symptom and have been hospitalized in Wuhan Union Hospital from Jan.,2005 to Jan.,2011, observe bone marrow smears of these patients under the oil immersion lens by using Swiss dyeing, then retrospectively analyze the number of the dysplastic cells which have been found in every hundred non-original neutrophils and erythocytes,and everyfifty megakaryocytes.Make a detailed document and a statistical analysis by applying the Excel sofeware and SPSS15.0 software pack accordingly. Meanwhile make it as a referrence to identify other cases such as MA , ITP, CML 20 cases for each and 7 cases of SLE where dysplastic cells can be foundResults: It's easy to see dysplasia in bone marrow platelets for MDS patients, but it also can be seen in other diseases. Bue the percent of dysplasia and the type of dysplasia in each series of each case are different. The percentage of dysplasia in other diseases is lower than 10%. The rates of Pseudo Pelger–Huet granulocytes and Micromegakaryocytes is bigger in the MDS than other diseases.Comparing MDS in WHO classification, karyotypic abnormality groups, IPSS classification: The value and rate of dysplasia in erythroid series have no statistical meaning (P>0.05); the value and the rate of hypogranularity , nuclear/cytoplasmic asynchrony , Pseudo Pelger–Huet granulocytes and micromegakaryocytes have statistiacal meaning(P﹤0.05). In RAEB,7q-/ the complex caryotype, the high risk group,the rates of them are 100%. It Suggests that hypogranularity , nuclear/cytoplasmic asynchrony , Pseudo Pelger–Huet granulocytes and micromegakaryocytes are unfavourable prognostic factors for MDS, and the dysplasia in erythroid series has no meaning for prognosis in MDS.Conclution:1 Quantitative analysis dysplasias in MDS has diagnostic meaning ,it can provide evidence for differential diagnosis between MDS and other diseases: compered to MDS, the percentage of dysplasia in other diseases is loewer than 10%;and the value and rate of some dysplasia(for example: Pelger–Huet granulocytes and Micromegakaryocytes) is very lower in other diseases than MDS.3 The type of dysplasias has influence to the prognosis of MDS: the hypogranularity nuclear/cytoplasmic asynchrony, Pseudo Pelger–Huet granulocytes and micromegakaryocytes are unfavourable influence to MDS.