CD56在正常核型急性髓系白血病患者中的表达及临床意义  

CD56 expression and its clinical significance in patients with cytogenetically normal acute myeloid leukemia

作　　者：宋娟娟 裴艳茹 李丹 肖梦宇 魏圣洁 白炎亮 孙恺 SONG Juan-juan;PEI Yan-ru;LI Dan;XIAO Meng-yu;WEI Shengjie;BAI Yan-liang;SUN Kai(Department of Hematology,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]郑州大学人民医院血液科河南省人民医院,河南郑州450003

出　　处：《中华实用诊断与治疗杂志》2021年第1期11-14,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金(81971508,81471589,81273259);河南省科技攻关计划省部共建项目(201201005);河南省科技厅基础与前沿项目(142300410078)。

摘　　要：目的分析正常核型急性髓系白血病(cytogenetically normal acute myeloid leukemia,CN-AML)患者骨髓白血病细胞中CD56表达情况,探讨CD56对CN-AML患者预后的影响。方法76例初诊CN-AML患者,应用流式细胞术检测骨髓白血病细胞中CD33、CD13、CD123、CD38、人类白细胞抗原(human leukocyte antigen,HLA)-DR、CD19、CD56、CD64、CD7、CD4、CD11b、CD14、CD15阳性表达,并均在评估病情后给予蒽环类药物联合阿糖胞苷标准诱导方案化疗。依据CD56表达是否≥20%,将76例患者分为CD56阳性组32例和CD56阴性组44例,比较2组临床特征及骨髓白血病细胞免疫表型特征、完全缓解率,随访1年观察复发率、总生存率和无事件生存率。结果CD56阳性组年龄[(50.9±16.1)岁]大于CD56阴性组[(38.56±15.2)岁](P<0.05),急性髓系白血病-M5亚型比率(31.3%)高于CD56阴性组(4.5%)(P<0.05),CD4、CD11b、CD14阳性表达率(43.8%、34.4%、28.1%)高于CD56阴性组(15.9%、13.6%、2.3%)(P<0.05);CD56阳性组与CD56阴性组白细胞计数、血小板计数、血红蛋白、乳酸脱氢酶、骨髓原始细胞比率、外周血原始细胞比率及CD33、CD13、CD123、CD38、HLA-DR、CD19、CD56、CD64、CD7、CD15阳性表达率比较差异均无统计学意义(P>0.05)。CD56阳性组完全缓解率(65.6%)、部分缓解率(18.8%)、复发率(47.6%)与CD56阴性组(68.2%、18.2%、40.0%)比较差异均无统计学意义(P>0.05),CD56阳性组1年总生存率(53.1%)和无事件生存率(50.0%)均低于CD56阴性组(77.3%、79.5%)(P<0.05)。结论CD56阳性表达可能提示CN-AML患者预后不良。Objective To analyze the expression of CD56 in bone marrow blasts of cytogenetically normal acute myeloid leukemia(CN-AML),and to investigate the influence of CD56 on the prognosis of CN-AML patients.Methods The positive expressions of CD33,CD13,CD123,CD38,human leukocyte antigen(HLA)-DR,CD19,CD56,CD64,CD7,CD4,CD11 b,CD14 and CD15 in bone marrow blasts were detected by flow cytometry in 76 newly diagnosed CN-AML patients.After assessment,all patients were treated with standard anthracyclines and cytarabine regimens for induction therapy.According to whether the expression of CD56 was≥20%,the patients were divided into CD56+group(n=32)and CD56-group(n=44).The clinical data,immunophenotypic characteristics and complete remission rates were compared between two groups.All patients were followed up for one year to observe the relapse rate,one-year overall survival rate and event-free survival rate.Results The patients in CD56+group((50.9±16.1)years)were older than the patients in CD56-group((38.56±15.2)years)(P<0.05).The proportion of FAB-M5 subtype was higher in CD56+group(31.3%)than that in CD56-group(4.5%)(P<0.05).The positive rates of CD4,CD11 b and CD14 were higher in CD56+group(43.8%,34.4%,28.1%)than those in CD56-group(15.9%,13.6%,2.3%)(P<0.05).There were no significant differences in white blood cell count,hemoglobin,platelet count,lactate dehydrogenase,blast counts in the bone marrow and in the peripheral blood,and the expression rates of CD33,CD13,CD123,CD38,HLA-DR,CD19,CD56,CD64,CD7 and CD15 between two groups(P>0.05).The complete remission rate,partial remission rate and relapse rate showed no significant differences between CD56+group(65.6%,18.8%,47.6%)and CD56-group(68.2%,18.2%,40.0%)(P>0.05).The one-year overall survival rate and event-free survival rate were lower in CD56+group(53.1%,50.0%)than those in CD56-group(77.3%,79.5%)(P<0.05).Conclusion The positive expression of CD56 may predict a poor prognosis in patients with CN-AML.

关 键 词：急性髓系白血病 CD56 免疫表型 预后 

分 类 号：R733.71[医药卫生—肿瘤]