慢性粒细胞白血病患者骨髓中白血病相关巨噬细胞的表达及意义  

Expression of leukemia-associated macrophage in bone marrow of Chronic Myeloid Leukemia patients and its clinical significance

作　　者：宋建新[1] 欧阳红梅[1] 汤一菲 蒋雅先[1] 闻艳[2] 梅芬[3] 甸自金[1] 撒亚莲[3] 

机构地区：[1]云南省第一人民医院血液病诊断室,昆明650032 [2]云南省第一人民医院血液科,昆明650032 [3]云南省第一人民医院临床基础研究所,昆明650032

出　　处：《国际检验医学杂志》2017年第1期4-6,9,共4页International Journal of Laboratory Medicine

基　　金：云南省科技厅-昆明医科大学联合专项应用基础研究资助项目(2014FZ070)

摘　　要：目的探讨慢性粒细胞白血病(CML)患者骨髓中巨噬细胞的表达及在CML发病中的作用,明确其临床意义。方法采用免疫组织化学染色法检测CML慢性期(CML-CP组)30例、加速期(CML-AP组)21例、急变期(CML-BP组)15例、经治疗后缓解患者44例、未缓解患者7例及30例非血液系统恶性疾病患者骨髓组织中CD68、CD163、CD206的表达变化,比较骨髓巨噬细胞在CML患者不同时期骨髓组织中的表达差异。结果 CML各组患者骨髓组织中CD68、CD163、CD206的表达明显高于对照组及缓解组,CML-BP组患者高于CML-AP组,CML-AP组高于CML-CP组,且差异均有统计学意义(P<0.01);缓解组CD68虽高于对照组但差异无统计学意义(P>0.05),而CD163、CD206仍高于对照组,且差异均具有统计学意义(P<0.01),未缓解组与CML-BP组相比有增高趋势,但差异无统计学意义(P>0.05);在对照组中CD163和CD206表达明显低于CD68的表达,且差异具有统计学意义(P<0.01),同时,CML-CP组、CML-AP组、CML-BP组、缓解组、未缓解组中CD163与CD68阳性细胞数密切相关(P<0.01),CD68的阳性细胞数略高于CD163,但差异无统计学意义(P>0.05);而在CML疾病的同一时期CD163、CD206的表达差异无统计学意义(P>0.05)。结论巨噬细胞在CML患者骨髓中具有较高的浸润密度,并随着病情的进展逐渐向M2型极化,且在CML不同时期浸润密度不同,与CML的发生、发展密切相关,同时也可能是CML患者复发的原因之一。而在骨髓组织中CD163、CD206均可作为识别M2型巨噬细胞的标志物。Objective To detect the expression of leukemia-associated macrophage,a type of white blood cell that expresses spe- cific proteins such as CD68,CD163. and CD206.in bone marrow of Chronic Myeloid Leukemia（CML）patients,and to investigate the clinical significances of tumor-associated macrophage in CML. Methods Bone marrow tissues were collected from 30 patients with CML in chronic phase（CML-CP）,21 patients in accelerated phase（CML-AP）, 15 patients in blastic phase（CML-BP）, and 44 CML patients who had a remission after treatment and 7 patients who did not.30 healthy volunteers were recruited as controls. Expres- sion of CD68,CD163, and CD206 was determined by immunohistochemistry staining with specific antibodies. Results Compared with patients who did not have a remission after treatment and the controls, the expression levels of CD68,CD163,and CD206 were increased in portents with CML-CP, CML-AP, CML-BP. CML-BP, and who had a remission after treatment, with an order as follows..CML-BP〉CML-AP〉CML-CP（P〈0. 01）. Tissues from patients who had a remission had higher values than the controls in expression levels of CD163 and CD206（P〈0.01） ,as well as CD68（P〉0.05） ,which showed no statistical difference though. In the controls, the expression levels of CD163 and CD206 were lower than CD68 （P〈0.01）. In addition, the number of positively-stained cells with CD163 correlated with CD68 in group CML-CP,CML-AP,CML-BP,as well as patients who had a remission after treat- ment and who did not（P〈0.01）;while for CD68.there were no statistical difference（P〉0.05）. Conclusion Macrophages were distributed in the bone marrow of CML patients with a high density of infiltration,with a trend of transformation to M2 macropha- ges as the disease progresses. Furthermore. the distribution density of macrophages was different in different stages of CML, closely related to the occurrence and development of CML. In bone marrow tissues,CD206 and CD163 can be used as markers to identify M2 macro

关 键 词：慢性粒细胞白血病 巨噬细胞 CD68 CD163 CD206 

分 类 号：R733.72[医药卫生—肿瘤]