中文摘要：

目的探讨骨髓增生异常综合征（MDS）患者体外集落形成细胞（CFC）培养特征及其与非重型再生障碍性贫血（NSAA）患者的异同。方法回顾性分析了初诊未治的155例MDS患者的EFC培养结果及其与其他相关实验室检查参数的相关性，并与初诊未治的122例NSAA患者体外CFC培养结果进行了比较分析。结果MDS患者红细胞爆式集落形成单位（BFU—E）中位数9（0～157）／10^5骨髓单个核细胞（BMMNC），红细胞集落形成单位（CFU-E）中位数30（0～625）／10^5BMMNC，粒一单该细胞集落形成单位（CFU—GM）中位数14（0—125）／10^5BMMNC，较正常参考值均显著减；66例（42．6％）仅BFU—E和（或）CFU—E低于正常下限，3例（1．9％）仅CFU—GM低于正常下限，70例（45．2％）BFU—E和（或）CFU—E且CFU．GM低于正常下限。MDS患者中集簇数同BFU—E、CFU—E及CFU．GM数均呈正相关（r值分别为0．415、0．338、0．642，P值均为0．000），同中性粒细胞碱性磷酸酶（N—ALP）阳性率和阳性积分均呈负相关（rm性率=-0．315，P=0．001；r日性积分=-0．257，P=0．006）。MDS组各类型集落中位数均明显高于NSAA组（BFU—E9对5／10^5BMMNC，P=0．017；CFU—E30对19．5／10^5BMMNC，P=0．023；CFU—GM14对10／10。BMMNC，P=0．003），两组内BFU—E和CFU—E均呈正相关（rMDS=0．712，P=0．000和rNSAA=0．757，P=0．000），MDS组相关度低于NSAA组（P〈0．05）。结论MDS起病初期造血祖细胞数量明显减少，且红系受累更为广泛而显著；BFU—E、CFU—E和CFU—GM能够反映出体内造血祖细胞水平但并非残存的正常造血克隆，集簇数代表了发育异常祖细胞克隆但不等同于白血病样原始细胞。

英文摘要：

Objective To investigate in vitro characteristics of colony-forming cells （CFC） in patients with myelodysplastie syndrome （MDS） and to compare that in patients with non-severe aplastic anemia （NSAA）. Methods Data of in vitro CFC and correlation with other related laboratory tests in 155 newly di- agnosed MDS patients were analyzed retrospectively, and to compare with data of in vitro CFC in 122 newly diagnosed NSAA patients. Results Median number of burst-forming units-erythroid （ BFU-E ） was 9 （0 - 157 ）/105 bone marrow mononuclear cells （ BMMNC ）, colony forming unit-erythroid （ CFU-E ） 30 （ 0 - 425 ） / 105 BMMNC and colony forming unit-granulocytes/macrophages （CFU-GM） 14 （0 - 125 ）/105 BMMNC in pa- tients with MDS, being significantly lower than those in healthy control; number of BFU-E and/or CFU-E was lower than the lower limit of normal control in 66 cases （42.6%）, CFU-GM lower in 3 cases （ 1.9% ） and BFU-E and/or CFU-E with CFU-GM lower in 70 cases （45.2%）. Cluster/CFU-GM ratio was significantly lower in low blast group （MDS 〈 5% blast in bone marrow smear） than that in high blast group （MDS I〉5% blast） （0.65 vs 1.0, P = 0. 049）. In all MDS patients, cluster had positive correlation with each type ofCFC （r =0.415, 0. 338, 0. 642 for BFU-E, CFU-E, CFU-GM, respectively, P =0.000）, but had negative correlation with neutrophil alkaline phosphatase （N-ALP） positive rate and scores （rrate ~ --0. 315, P = 0.001 and r = -0.257, P =0. 006）. The median number of each type of CFC was significantly higher in MDS group than that in NSAA group （BFU-E 9 vs 5/105BMMNC, P = 0. 017; CFU-E 30 vs 19. 5/ 105BMMNC, P =0. 023 ; CFU-GM 14 vs 10/105BMMNC, P =0. 003, respectively）. Positive correlation be- tween BFU-E and CFU-E were revealed in both MDS and NSAA group （rMos = 0. 712, P = 0. 000 and rNsnA = O. 757, P = 0. 000）, with a lower correlation coefficient in MDS （ P 〈 0.05 ）. Conclusions Early onset MDS present markedly decreased