多参数流式细胞技术分析髓系白血病细胞相关免疫表型  

On Immunophenotypes of Myeloid Leukemia Cells by Using Multiparameter Flow Cytometry

作　　者：王艺潼 姜佳彤 吴金娜 刘天月 武风云 宋玉国 WANG Yitong;JIANG Jiatong;WU Jinna;LIU Tianyue;WU Fengyun;SONG Yuguo(School of Medical Technology,Beihua University,Jilin 132013,China;Affiliated Hospital of Beihua University,Jilin 132011,China)

机构地区：[1]北华大学医学技术学院,吉林吉林132013 [2]北华大学附属医院,吉林吉林132011

出　　处：《北华大学学报（自然科学版）》2024年第4期460-465,共6页Journal of Beihua University（Natural Science）

基　　金：北华大学研究生创新计划项目(2022019)。

摘　　要：目的 探讨常见的急性髓系白血病细胞相关免疫表型,并阐述其在临床中的应用价值。方法 应用多参数流式细胞技术分析47例急性髓系白血病(AML)患者骨髓标本中白血病细胞相关免疫表型,并对其免疫分型结果与治疗、预后的相关性进行统计分析,进而探讨AML免疫分型在临床中的应用。结果 47例AML患者阳性高表达的髓系抗原有CD33(93.62%)、CD13(89.36%)、MPO(89.36%)、CD117(82.98%)、CD64(38.30%);造血干/祖细胞CD分子阳性表达以CD38(93.62%)、CD34(65.96%)、HLA-DR(51.06%)为主;其他抗原以CD56(48.94%)、CD7(23.40%)、CD19(19.15%)为主。经相同时间治疗后,23例(48.94%)AML患者病情得到完全缓解,患者阳性表达T细胞系抗原CD7的完全缓解率显著低于阴性患者(P<0.05)。6例(26.09%)患者在1 a内复发,没有任何一种抗原表达情况与之有关(P>0.05)。随访结束后,有26例(55.32%)患者死亡,阳性表达NK细胞系抗原CD56和T细胞系抗原CD7患者的死亡率显著性高于阴性表达的患者,阳性表达B细胞系抗原CD19的患者死亡率显著性低于阴性表达的患者(P<0.05),幼稚标志与成熟标志不同步的患者死亡率高于幼稚标志与成熟标志同步的患者(P<0.05)。结论 髓系抗原CD33、CD13、MPO、CD117、CD64是AML诊断中可靠的抗原标志物,AML患者的免疫分型结果可为临床医生确定治疗方案和判断预后提供参考。Objective To investigate the immunophenotypes of acute myeloid leukemia(AML)cells and its clinical application value.Method Forty-seven patients with acute myeloid leukemia were enrolled.Multipa-rameter flow cytometry was used to analyze the immunophenotypes of leukemia cells in bone marrow samples,and the correlation between immunophenotyping results,treatment and prognosis was statistically analyzed.Further-more,the clinical application of AML immunophenotyping was explored.Results The positive and highly expre-ssed myeloid antigens in 47 AML patients were CD33(93.62%),CD13(89.36%),MPO(89.36%),CD117(82.98%)and CD64(38.30%).Hematopoietic stem/progenitor cells mainly expressed in CD38(93.62%),CD34(65.96%)and HLA-DR(51.06%).Other antigens were mainly CD56(48.94%),CD7(23.40%)and CD19(19.15%).After the same treatment,23 patients(48.94%)achieved complete remission,and the complete remission rate of patients with positive expression of T cell line antigen CD7 was significantly lower than that of patients with negative expression of CD7(P<0.05).Six patients(26.09%)relapsed within 1 year,and there was no correlation between the expression of any of the antigens(P>0.05).After the follow-up,26 patients(55.32%)died,the mortality of patients with positive expression of NK cell antigen CD56 and T cell antigen CD7 was significantly higher than that of patients with negative expression,and the mortality of patients with positive expression of B cell antigen CD19 was significantly lower than that of patients with negative expression(P<0.05).The mortality rate of patients with immature and mature markers out of synchronous was significantly higher than that of patients with synchronous markers(P<0.05).Conclusion Myeloid antigens CD33,CD13,MPO,CD117 and CD64 are reliable antigen markers in the diagnosis of AML.The immunophenotyping results of AML patients are of great significance for clinicians in determining treatment options and judging prognosis.

关 键 词：多参数流式细胞技术 急性髓系白血病 白血病细胞相关免疫表型 CD分子 

分 类 号：R542.2[医药卫生—心血管疾病]