神经细胞黏附分子阳性初治原发急性髓系白血病临床特点分析  

Analysis on clinical features of initially treated primary AML with neural cell adhesion molecule positive

作　　者：姜艳红 陈光意 盛家和 许青霞 JIANG Yanhong;CHEN Guanyi;SHEN Jiahe;XU Qinxia(Department of Clinical Laboratory,Affiliated Tumor Hospital of Zhengzhou University,Zhengzhou,Henan 450008,China)

机构地区：[1]郑州大学附属肿瘤医院检验科,郑州450008

出　　处：《重庆医学》2018年第35期4491-4496,共6页Chongqing medicine

摘　　要：目的分析神经细胞黏附分子(CD56)阳性的初治原发急性髓系白血病(AML)患者的临床特征。方法回顾性分析2015年1月至2016年12月该院血液科144例初治原发AML住院患者的临床资料,其中男76例,女68例,根据患者免疫分型是否伴有CD56表达,分为CD56+组(n=48)和CD56-组(n=96)。分别采用t检验、秩和检验或χ~2检验比较各组临床特征的差异。结果 CD56+组出现发热症状、AML-M2b亚型、伴有AML-ETO融合基因和IKZF1基因突变患者比例高于CD56-组(χ~2=4.064、11.359、11.359、4.781,P<0.05);CD56+组出现乏力症状、出血、AML-M3亚型、伴有PML-RARA融合基因和DNMT3A基因突变患者比例低于CD56-组(χ~2=4.704、5.262、6.272、4.013、4.442,P<0.05)。结论 CD56+患者多为WHO急性髓系白血病分型中伴有重现性遗传学异常的M2b型,常见发热症状,易伴IKZF1基因突变;而少见WHO急性髓系白血病分型中伴有重现性遗传学异常的M3型、乏力和出血症状,少伴DNMT3A基因突变。Objective To analyze the clinical features in the patients with initially treated primary acute myeloid leukemia(AML)with neural cell adhesion molecule(CD56)positive.Methods The clinical data in 144 cases of initially treated primary AML in the hematological department of this hospital from January 2015 to December 2016 were retrospectively analyzed,including 76 male cases and 68 female cases,and divided into the CD56+group(n=48)and CD56-group(n=96)according to whether the immune type complicating CD56 expression.The differences of clinical features were compared between the two groups by adopting the t test,rank-sum test and chi square test.Results The proportion of appearing fever symptom,AML-M2b subtype,complicating AML-ETO fusion gene and IKZF1 gene mutation in the CD56+group was higher than that in the CD56-group(χ^2=4.064,11.359,11.359,4.781,P<0.05).The proportion of appearing fatigue,bleeding,AML M3 subtype,complicating PML-RARA fusion gene and DNMT3A gene mutation in the CD56^+group was lower than that in the CD56-group(χ^2=4.704,5.262,6.272,4.013,4.442,P<0.05).Conclusion The majority of the patients with CD56+are the complicating reproducible genetic abnormalities of type M2b,the fever symptom is common,is easily accompanied with gene mutation;whereas complicating reproducible genetic abnormalities of type M3 in the classification of acute myelogenous leukemia by WHO,fatigue and bleeding symptoms are rare,which is rarely accompanied with DNMT3 gene mutation.

关 键 词：神经细胞黏附分子类 CD56 白血病 髓样 急性 临床特征 

分 类 号：R733.71[医药卫生—肿瘤]