急性髓性细胞白血病免疫分型特点及其与疗效、预后关系的研究  

Immunophenotyping Features of Acute Myeloid Leukemia and Their Relationship with Curative Effect and Prognosis

作　　者：杨淳[1] 张莺莺[1] 张军[2] YANG Chun;ZHANG Yingying;ZHANG Jun(Laboratory Department,Yijishan Hospital of Wannan Medical College,Wuhu 241001,China;Hematology Department,Yijishan Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院弋矶山医院检验科,安徽芜湖241001 [2]皖南医学院弋矶山医院血液科,安徽芜湖241001

出　　处：《标记免疫分析与临床》2021年第3期462-465,523,共5页Labeled Immunoassays and Clinical Medicine

基　　金：国家自然科学基金面上项目(编号:81870017)。

摘　　要：目的分析急性髓性细胞白血病(AML)免疫分型特点及其与疗效、预后的关系。方法收集本院收治的86例AML初诊患者的临床资料,统计所有患者的免疫分型结果、治疗1个疗程后的效果及1年内复发情况,分析免疫分型结果特征及其对治疗效果、复发情况的影响。结果86例AML患者髓系抗原中表达阳性率前五位由高到低依次为:CD33(87.21%)、CD117(86.05%)、CD13(84.88%)、MPO(83.72%)、CD64(41.86%);造血干/祖细胞标记抗原中阳性表达以HLA-DR(58.14%)、CD38(55.81%)、CD34(52.33%)、CD123(50.00%)为主;淋系抗原中阳性表达以CD58(30.23%)、CD9(17.44%)、CD7(13.95%)、CD56(13.95%)为主。1个疗程治疗后,有63例(73.26%)患者获得缓解,4种髓系抗原(CD33、MPO、CD64、CD15)和CD58阳性表达患者的CR率明显高于阴性表达患者;而CD34阳性表达患者的CR率明显低于阴性表达患者,差异均有统计学意义(P<0.05)。有19例(30.16%)患者在1年内复发,CD34阳性表达、CD64阴性表达患者的复发率明显较高,差异均有统计学意义(P<0.05)。结论CD33、CD117、CD13、MPO、CD64是AML患者常见的免疫分子标志物,AML患者的免疫分型与患者的治疗效果存在一定的关联,对预后判断可能具有一定的指导意义。Objective To analyze the immunophenotyping features of acute myeloid leukemia(AML)and their relationship with curative effect and prognosis.Methods The clinical data of 86 AML newly diagnosed patients who were admitted to the hospital were collected for the study.The immunophenotyping results of all patients,curative effect after 1 treatment course and recurrence within 1 year were statistically analyzed.The immunophenotyping features and their influences on curative effect and recurrence were analyzed.Results In 86 AML patients,the top five myeloid antigens with positive expression rates were CD33(87.21%),CD117(86.05%),CD13(84.88%),MPO(83.72%)and CD64(41.86%).Among the hematopoietic stem/progenitor cell marker antigens,the positive expression was mainly on HLA-DR(58.14%),CD38(55.81%),CD34(52.33%)and CD123(50.00%).Among lymphoid antigens,the positive expression was mainly on CD58(30.23%),CD9(17.44%),CD7(13.95%)and CD56(13.95%).After 1 course of treatment,there were 63 cases(73.26%)relieved.CR rate in patients with positive expression of 4 kinds of myeloid antigens(CD33,MPO,CD64,CD15)and CD58 was significantly higher than that with negative expression,while CR rate in patients with positive expression of CD34 was significantly lower than that with negative expression(P<0.05).There were 19 cases(30.16%)with recurrence within 1 year.The recurrence rate was significantly higher in patients with positive expression of CD34 and negative expression of CD64(P<0.05).Conclusion CD33,CD117,CD13,MPO and CD64 are the common immune molecular markers in AML patients.There is a certain correlation between immunophenotyping and curative effect in AML patients,which suggests a promising guidance significance for prognosis determination.

关 键 词：急性髓性细胞白血病 免疫分型 预后 治疗效果 流式细胞术 

分 类 号：R733.71[医药卫生—肿瘤]