急性髓样白血病干细胞CD200的表达及与疗效的相关分析  

Expression of CD200 in acute myeloid leukemia stem cells and its correlation with clinical efficacy

作　　者：郑晓燕[1] 贺超奇[2] 陈芳建[1] 黄卉 吴芬芝[3] 詹碧翠[4] Zheng Xiaoyan;He Chaoqi;Chen Fangjian;Huang Hui;Wu Fenzhi;Zhan Bicui(Department of Clinical Laboratory,Quzhou People's Hospital,Quzhou 324000,China;Department of Clinical Laboratory,the First People's Hospital of Xiaoshan District,Hangzhou 311200,China;Department of Hematology,Quzhou People's Hospital,Quzhou 324000,China;Department of Clinical Laboratory,Hangzhou Chinese Medicine Hospital,Hangzhou 310014,China)

机构地区：[1]衢州市人民医院检验科,浙江衢州324000 [2]杭州市萧山区第一人民医院检验科,杭州311200 [3]衢州市人民医院血液科,浙江衢州324000 [4]杭州市中医院检验科,杭州310014

出　　处：《中华危重症医学杂志（电子版）》2018年第1期35-40,共6页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：浙江省科技厅公益技术研究社会发展项目(2013C33SA100139);杭州市科技局项目(20140633B50);衢州市科技局项目(2015064)

摘　　要：目的探究急性髓样白血病(AML)患者白血病干细胞(LSCs)中CD200的表达以及其与临床疗效的相关性。方法收集2014年4月至2017年4月衢州市人民医院收治的137例AML患者,进行AML分型,分为M1~M5型。并对患者临床疗效进行统计,分为三组:完全缓解(CR)组(59例)、部分缓解(PR)组(47例)和未缓解(NR)组(31例)。通过流式细胞仪分离患者治疗前后的骨髓LSCs,检测LSCs表达、CD200在LSCs中的表达水平。结果 24.82%(34/137)AML患者的LSCs中表达CD200,且CD200在AML各亚型中表达的阳性占比的比较,差异有统计学意义(5/11、13/26、4/35、3/22、9/43,χ~2=16.533,P=0.002)。AML-LSCs在AML各亚型中都存在高表达,且差异无统计学意义(F=0.980,P=0.421);除CD200在M3组的LSCs中呈现更低表达外[(10.1±2.7)%],其在AML其他各亚型中表达差异均无统计学意义[(16.5±2.8)%、(19.7±4.0)%、(16.4±2.4)%、(17.0±3.1)%,P均>0.05]。而在治疗疗效观察中,治疗前CD200在LSCs中的表达水平在CR、PR、NR三组间比较,差异均无统计学意义(P均>0.05);治疗后随着症状的缓解程度提高,各组CD200在LSCs中表达水平也随之降低[(16.4±3.6)%、(10.8±2.6)%、(5.0±1.8)%,P均<0.05]。治疗后,CR与NR两组CD200阳性表达占比的比较,差异有统计学意义(5/59 vs.14/31,P<0.017);同时AML亚型分组中M3组内的CR、PR、NR三组CD200+/CD200-分布情况的比较,差异有统计学意义(0/22、1/11、1/0,χ~2=17.786,P<0.001)。结论 AML患者LSCs中高表达CD200与不良预后有一定关系,可影响临床疗效。Objective To investigate the expression of CD200 in leukemia stem cells(LSCs)from the patients with acute myeloid leukemia(AML)and its correlation with clinical efficacy.Methods A total of 137 AML patients admitted to Quzhou People's Hospital from April 2014 to April 2017 were collected and divided into M1-M5 types,according to AML classification.Based on the clinical efficacy,AML patients were also statistically divided into three groups:complete remission(CR)group(n=59),partial remission(PR)group(n=47)and non-remission(NR)group(n=31).The flow cytometry was used for separating bone marrow LSCs and detecting the expressions of LSCs and CD200 in LSCs before and after treatment.Results 24.82%(34/137)AML patients had CD200 expression in LSCs,while the positive proportions of CD200 expression in each subtype of AML were significantly different(5/11,13/26,4/35,3/22,9/43;χ2=16.533,P=0.002).AML-LSCs had high expressions in all AML subtypes,which showed no significant difference(F=0.980,P=0.421);except that the expression of CD200 in the LSCs was obviously lower in the M3 group[(10.1+2.7)%],the CD200 expressions were no difference in the other AML subtypes[(16.5±2.8)%,(19.7±4.0)%,(16.4±2.4)%,(17.0±3.1)%,all P>0.05].The treatment effect observation showed that the expressions of CD200 in the LSCs were not statistically significantly different among CR,PR and NR groups before treatment(all P>0.05);the expression of CD200 in the LSCs decreased with the improvement of symptoms after treatment[(16.4±3.6)%,(10.8±2.6)%,(5.0±1.8)%,all P<0.05].There was a significant difference of CD200 positive expression between CR and NR groups after treatment(5/59 vs.14/31,P<0.017);in addition,the comparison of CD200+/CD200-in CR,PR,NR subgroups of AML M3 group was significantly different(0/22,1/11,1/0;χ2=17.786,P<0.001).Conclusion The high expression of CD200 in LSCs of AML patients has a certain relationship with poor prognosis,which can affect the clinical efficacy.

关 键 词：白血病 髓样 急性 CD200 临床疗效 

分 类 号：R733.71[医药卫生—肿瘤]