176例成人急性髓细胞白血病免疫表型分析及其与疗效、复发关系的研究  

Phenotype Analysis in Adult Acute Myeloid Leukemia and Its Relationship with Remission/Recurrence

作　　者：宋斌[1] 陈雁[1] 吴修伟 常娟[1] 周璐[1] 张荣耀[1] 李章志[1] 张霞[1] 章正华[1] 万楚成[1] 

机构地区：[1]十堰市太和医院湖北医药学院附属医院血液科,湖北十堰442000

出　　处：《标记免疫分析与临床》2016年第11期1337-1340,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨成人急性髓细胞白血病(AML)免疫表型的特点及其与疗效、复发的关系。方法选择2013年2月至2014年2月期间在我院血液科进行治疗的176例成年AML患者进行免疫表型检测,随访观察24个月,记录复发的数据。结果 176例AML患者中髓系特异性抗原主要阳性表达依次为CD13(165例、93.75%)、CD117(115例、65.34%)、CD33(109例、61.93%)、MPO(81例、46.02%)、CD64(51例、28.98%);造血干/祖细胞标记抗原主要阳性表达依次为CD38(122例、69.32%)、HLA-DR(94例、53.41%)、CD34(85例、48.30%),在176例AML患者中伴有淋系抗原阳性表达的有79例,主要为CD56(58例、32.95%)、CD7(31例、17.61%)。在176例患者中,123位患者化疗1至2个疗程后达到完全缓解,其中:HLA-DR、CD34、CD7、CD19等4个抗原表达阳性的患者的缓解率低于表达为阴性的患者(P<0.05);在24个月的随访观察中,123例得到缓解的患者当中25例出现复发,其中患者HLA-DR、CD34、CD7阳性表达的患者复发比例高(P<0.05)。结论 CD13、CD33、CD38等抗原在AML患者中表达较高,其中44.88%的患者伴有淋系抗原的表达;而患者具有CD7、CD34、CD56、HLA-DR表达阳性后出现缓解的预期值相对较低,当患者出现CD34、CD56、HLA-DR表达阳性后增加其复发的概率。Objective To investigate the immune phenotype characteristics of adultacute myeloid leukemia（ AML） and its efficacy. Methods We selected 176 cases of adult AML patients who were admitted in our hospital hematology treatment from February 2013 to February 2014. Immunophenotyping was performed in all subjects and patients were followed up for 24 months. Results AML patients with positive expression in myeloid-specific antigen were CD13（ 165 Li,93. 75%）,CD117（ 115 Li,65. 34%）,CD33（ 109 Li,61. 93%）,MPO（ 81 cases,46. 02%）,CD64（ 51 cases,28. 98%）. Hematopoietic stem and progenitor cell marker antigen expression of major / were CD38（ 122 Li,69. 32%）,HLA-DR（ 94 Li,53. 41%）,CD34（ 85,48. 30%）. Lymphoid antigen expression was found in 79 cases out of 176 cases of AML patients,mainly for CD56（ 58 Li,32. 95%）,CD7（ 31 cases,17. 61%）. 123 patients with chemotherapy 1-2 rounds achieved complete remission. HLA-DR,CD34,CD7,CD19 positive expression rates were lower in complete remission patients（ P 〈 0. 05）. After 24 month follow-up,25 out of 123 patients had recurrence. The patients with HLADR,CD34,CD7 expression had higher recurrent rate（ P 〈 0. 05）. Conclusion CD13,CD33,CD38 expressions were higher in AML patients,of which 44. 88% patients had lymphoid antigen expression. The patients who had positive CD7,CD34,CD56 and HLA-DRwere less likely to go into remissions. The patients who had positive CD34,CD56 and HLA-DR expression were more likely to have recurrence.

关 键 词：AML 免疫表型 化疗 效果 复发 

分 类 号：R733.71[医药卫生—肿瘤]