CD47在急性髓细胞白血病干细胞中的表达及其临床意义探讨  

CD47 Receptor Expression in AML LSCs and Its Clinical Signification

作　　者：李婉红[1] 陈葆国[2] 郑瑞[2] 李伯利[2] 

机构地区：[1]浙江省台州市中心医院输血科,318000 [2]温州医学院附属浙江省台州医院中心实验室,临海317000

出　　处：《医学研究杂志》2012年第6期27-31,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(31170879);台州市"211人才工程"基金资助项目[台人专(2009)236号]

摘　　要：目的探讨CD47在急性髓细胞白血病干细胞(AML LSCs)中的表达及临床意义。方法应用流式细胞仪检测19名健康对照者骨髓造血干细胞(HSC)及147例AML患者骨髓LSCs中CD47的表达。对其中131例AML患者进行跟踪随访,分析LSCs CD47阳性和阴性对AML预后的影响。结果 19名健康对照骨髓HSC CD47阳性4例(21.05%),147例AML患者LSCs CD47阳性112例(76.19%),明显高于对照组,差异有统计学意义(χ2=24.30,P<0.01)。CD47在LSCs中表达百分率和平均荧光强度(MFI)均高于CD34+CD38+亚群(U值分别为4.90、3.03,P均<0.01)。对131例AML进行1～31个月随访:CD47阳性的AML患者复发率为46.46%(46/99),病死率为43.43%(43/99),CD47阴性的AML患者复发率为25.00%(8/32),病死率为18.75%(6/32),两者差异有统计学意义(χ2值分别为4.60、6.29,P均<0.05)。生存分析显示,CD47阳性的AML患者平均生存时间18.99±1.15个月,CD47阴性的AML患者平均生存时间24.90±1.87个月,两者差异有统计学意义(P<0.05)。结论 LSCs CD47阳性的AML患者易复发、病死率高、生存时间短、预后差。Objective To investigate CD47 receptor expression in acute myelogenous leukemia stem cells（AML LSCs） and its clinical signification. Methods Totally 19 normal human bone marrow controls and 147 AML patients were tested. CD47 receptor expression in hematopoietic stem ceils （HSCs） and leukemia stem ceils were analyzed using flowcytometry. Results CD47 was more highly ex- pressed in AML LSCs（76.19% ） than in normal bone marrow HSCs（21.05% ） （P 〈 0.01 ）. The percentage and mean fluorescent intensi- ty（MFI） of CD47 expression in LSCs were significantly higher than CD34 ＋ CD38＋ subset （ P 〈 0.01 ）. After 1 - 31 months follow up, the recurrence rate and death rate were analyzed between CD47 positive and CD47 negative AML patients,and they all had statistically signifi- cant defferences. Kaplan - Meier analysis demonstrated that patients in CD47 positive expression group had a overall survival of（ 198.99 ± 1.15 ） months compared to（24.90 ± 1.87 ） months in the CD47 negative expression group, and they had statistical difference （ P 〈 0.05 ）. Conclusion CD47 positive expression in AML LSCs was significantly associated with higher recurrence and death rate,worse overall sur- vival and prognosis.

关 键 词：急性髓系白血病 白血病干细胞 CD47 

分 类 号：R[医药卫生]