CD15在初诊急性髓系白血病患者中表达及预后意义  

Prognostic significance of CD15 expression in de novo acute myeloid leukemia

作　　者：陈惠娟 曹阳[1] 缪颖洁 周怡芳 刘月 顾伟英[1] CHEN Hui-juan;CAO Yang;MIAO Ying-jie;ZHOU Yi-fang;LIU Yue;GU Wei-ying(Department of Hematology,the Third Affiliated Hospital o Soochow University(the First People's Hospital of Changzhou),Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院(常州市第一人民医院)血液科,江苏常州213003

出　　处：《中国实用内科杂志》2024年第4期296-301,共6页Chinese Journal of Practical Internal Medicine

基　　金：常州市十四五卫生领军人才工程资助项目(KY20221336);江苏省卫生健康委员会重点项目(ZD2021043)。

摘　　要：目的分析CD15在初诊的急性髓系白血病(AML)患者中的表达和预后意义,探讨其与白血病靶基因突变的关系。方法回顾分析2018年1月1日至2022年4月30日于常州市第一人民医院初诊的186例AML患者(除外M3亚型)的临床资料,比较CD15阳性(CD15^(+))组和CD15阴性(CD15^(-))组患者之间的临床特征及预后差异。结果与CD15^(-)组相比,CD15^(+)组AML患者相对年轻(61.0岁比67.0岁,P=0.012),初诊时白细胞计数(13.1×10^(9)/L比6.3×10^(9)/L,P=0.027)和乳酸脱氢酶水平(442.0 U/L比287.0 U/L,P=0.023)更高,具有更高比例的M5亚型(31.0%比12.8%,P=0.003)。CD15^(+)组CEBPA突变比率(24.0%比10.7%,P=0.020)高于CD15^(-)组,IDH2突变比率(8.3%比28.6%,P<0.001)低于CD15^(-)组。CD15^(+)组和CD15^(-)组1~2个疗程诱导治疗后完全缓解(CR)率分别为54.0%和34.9%(P=0.009)。CD15^(+)组患者中位数总生存期(mOS)为418 d,明显长于CD15^(-)组223 d(P=0.027)。结论CD15阳性表达提示预后良好,CD15^(+)组和CD15^(-)组之间CEBPA突变和IDH2突变存在差异。Objective To analyze the expression and prognostic significance of CD15 in newly diagnosed acute myeloid leukemia(AML)patients,and to investigate the relationship between CD15 expression and leukemia target gene mutations.Methods The clinical data of 186 newly diagnosed AML patients(except the M3 subtype)who were newly diagnosed at the First People′s Hospital of Changzhou from January 1,2018 to April 30,2022 were retrospectively analyzed.Clinical characteristics and prognostic differences were compared between CD15-positive group(CD15^(+))and CD15-negative group(CD15^(-))patients.Results Compared with the CD15^(-)group,AML patients in the CD15^(+)group were relatively young(61.0 vs.67.0,P=0.012),had higher white blood cell counts(13.1×10^(9)/L vs.6.3×10^(9)/L,P=0.027)and lactate dehydrogenase levels(442.0 U/L vs.287.0 U/L,P=0.023)at initial diagnosis,had a higher proportion of M5 subtype(31.0%vs.12.8%,P=0.003).The ratio of CEBPA mutation(24.0%vs.10.7%,P=0.020)was higher in the CD15^(+)group than in the CD15^(-)group,yet the ratio of IDH2 mutation(8.3%vs.28.6%,P<0.001)was lower.The complete remission(CR)rate induced by 1-2 courses of treatment was 54.0%in the CD15^(+)group and 34.9%in CD15^(-)group(P=0.009).The median overall survival(mOS)was 418 days in the CD15^(+)group and 223 days in the CD15^(-)group,and the mOS was significantly longer in the CD15^(+)group than in the CD15^(-)group(P=0.027).Conclusion Positive expression of CD15indicates a good prognosis.CEBPA and IDH2 mutations differes between CD15^(+)and CD15^(-)AMLs.

关 键 词：CD15 急性髓系白血病 预后 基因突变 

分 类 号：R55[医药卫生—血液循环系统疾病]