Quantitative Analysis Of Immunophenotype Of CD34~+ Myeloid Precursor Cells In Myelodysplastic Syndrome And Its Correlation With Clinical Features

Objective:To analyze and compare the quantitative expression of surface immune markers in CD34~+myeloid precursor cells in patients with low risk,high risk myelodysplastic syndrome(MDS)based on the proportion and the mean fluorescence intensity(MFI)of antigen expression;To explore its correlation with clinical and laboratory charact-eristics of patients;To understand the effect of surface CD7?CD117 and quantitative expression of CD34~+myeloid precursor cells on the prognosis of patients with low risk MDS.Methods:1.Clinical and laboratory characteristics of low risk and high risk MDS patientsThe clinical and laboratory characteristics of 79 MDS patients diagnosed between January 2015 and January 2018 in the second hospital of Shanxi medical university(32 in the low risk group and 47 in the high risk group)were collected.The clinical characteristics such as sex and age were collected;laboratory features such as bone marrow primary cell ratio,peripheral blood WBC count,PLT count,Hb level,neutrophil absolute count,LDH level,complex karyotype,and gene mutation.Clinical and laboratory characteristics of low and high risk MDS patients were compared.2.The quantitative expression of CD34~+myeloid precursor cell surface antigen in low and high risk MDS patientsBy multi-parameter flow cytometry to detect the proportion and average fluorescence intensity of CD34~+myeloid precursor cell surface CD15?CD11b?CD10?CD19?CD38?CD123?CD7?CD56?CD117?HLA-DR?CD71 in low risk and high risk patients,and to compare the quantitative expression of each antigen in low risk and high risk patients.3.The correlation between the expression level of CD34~+myeloid cell surface antigen and laboratory characteristic data in low risk and high risk MDS patientsTo analyze and compare the correlation between CD34~+myeloid precursor cell surface CD15?CD11b?CD10?CD19?CD38?CD123?CD7?CD56?CD117?HLA-DR?CD71 and laboratory characteristic data such as peripheral blood WBC count,PLT count,Hb level,neutrophil absolute count,LDH level,etc.4.The effect of quantitative expression of CD7,CD117,CD123 on the overall survival of low risk MDS patientsThrough the inpatient medical records system,electronic medical records and telephone follow-up to understand the survival of low-risk MDS patients,the overall survival(OS)time from the beginning of the diagnosis of the disease to the death or follow-up deadline.To analyze the effect of the proportion and mean fluorescence intensity of CD7,CD117,CD123 in CD34~+myeloid precursor cells on the overall survival of low risk MDS patients.Results:1.The clinical and laboratory characteristics of 79 patients low risk and high risk MDS patients were compared.The proportion of bone marrow primary cells in low risk MDS patients was significantly lower than that in high risk patients(P<0.001),while erythropoietin levels were higher than those high risk MDS patients(P=0.024).RBC levels and Hb levels were lower in low risk MDS patients than in high risk MDS patients(P=0.009,P=0.021).2.To compare the quantitative expression of CD34~+myeloid precursor cell surface antigen in low and high risk MDS patients,the proportion CD34~+primary cells in low risk patients was lower than that in high risk patients(P<0.001).The MFI of CD123 on CD34~+myeloid precursor cell was higher in low risk patients(P=0.044),lower in CD117(P=0.046)and lower in CD7(P=0.031).3.To study the correlation between surface antigen expression level of CD34~+myeloid precursor cells and laboratory characteristics in low risk and high risk MDS patients.High risk MDS:CD15/CD34(MFI),CD19/CD34(MFI)were positively correlated with the proportion of total T cells(r=0.458,P=0.004;r=0.505,P=0.023).CD19/CD34(%)?CD19/CD34(MFI)was negatively correlated with WBC levels(r=-0.469,P=0.028;r=-0.503,P=0.017).Low risk MDS:CD34(%)were positively correlated with bone marrow erythrocyte ratio,Hb level,neutrophil level(r=0.426,P=0.024;r=0.486,P=0.009;r=0.495,P=0.009),but negatively correlated with LDH level(r=-0.421,P=0.032).CD10/CD34(%)?CD10/CD34(MFI)?CD117/CD34(MFI)were positively correlated with WT1(r=0.745,P=0.021;r=0.800,P=0.01;r=0.434,P=0.049),but CD11b/CD34(%)negatively correlated with WT1(r=-0.457,P=0.033).CD19/CD34(%)?CD71/CD34(MFI)was negatively correlated with NK cell ratio(r=-0.786,P=0.036;r=-0.514,P=0.042).CD10/CD34(%)was positively correlated with Th/Ts,and CD7/CD34(MFI)was negatively correlated with the ratio of Th cells(r=0.738,P=0.037;r=-0.513,P=0.017).HLA-DR/CD34(%)?HLA-DR/CD34(MFI)was negatively correlated with PLT level(r=-0.461,P=0.027;r=-0.445,P=0.033),but HLA-DR/CD34(MFI)was positively correlated with bone marrow NAP fraction(r=0.552,P=0.041).CD71/CD34(MFI)was negatively correlated with NK cell ratio(r=-0.514,P=0.042).4.To investigate the effect of quantitative expression of CD7,CD117,CD123 on the overall survival of low risk MDS patients,the proportion and average fluorescence intensity of CD34~+myeloid precursor cells in low risk MDS patients had no significant effect on the overall survival rate.Conclusions:1.Bone marrow primary cell ratio,red blood cell count,hemoglobin concentration and erythropoietin level are related to different prognostic subgroups MDS patients.2.The proportion CD34~+primitive cells and the expression of surface CD7?CD117?CD123 of CD34~+myeloid precursor cells were significantly different in patients with low risk and high risk MDS,suggesting quantitative analysis of the immunophenotype of CD34~+myeloid precursor cells may be used for further clinical typing and prognostic evaluation in patients with low risk MDS.3.Immunophenotype of CD34~+myeloid precursor cells in patients with low risk and high risk has some correlation with blood routine,anemia,immune cell subsets,bone marrow cell morphology ratio,WT1,NAP and other clinical and laboratory indicators,and has certain differences.Comprehensive bone marrow cell morphology,clinical and laboratory characteristics,immunophenotype and other indicators will be important for the diagnosis,differential diagnosis and prognosis evaluation of MDS patients.4.Proportion of CD34~+myeloid precursor cell surface CD7,CD117,CD123 and mean fluorescence intensity had no significant effect on overall survival in patients with low risk MDS.