急性髓系白血病免疫分型特点及与疗效相关性分析简

本研究旨在探讨急性髓系白血病（acute myeloid leukemia,AML）的免疫分型特点及其与疗效的关系.收集516例初发AML患者骨髓标本,采用流式细胞术检测AML的免疫表型.结果表明,①516例AML中髓系相关抗原阳性表达率较高,依次为MPO（95.0％）、CD33（93.0％）、CD13（88.8％）、CD117 （69.4％）,而CD14、CD15、CD64、CD71表达较低,其中145例AML伴淋系抗原表达,分别为CD7 21.5％、CD19 6.0％、CD2 0.78％、CD100.58％、CD20 0.58％;CD71在M6中阳性表达率为100％,CD64在M5中阳性表达率最高（30.2％）;CD34总阳性表达率为57.8％.②首次化疗后完全缓解（CR）率为64.7％,M3组中CD34＋患者CR率低于CD34-组（P=0.019）.非M3组CD34阳性组的CR明显低于CD34阴性组（P=0.002）;CD19＋患者CR率高于CD19-组（P=0.028）;CD7＋患者CR率明显低于CD7-组（P =0.002）;CD71＋患者CR率低于CD71-组（P=0.013）;MPO＋患者CR率高于MPO-组（P=0.015）;CD11b、CD13、CD33表达阳性组与相应阴性组的CR率相比,差异无统计学意义（P＞0.05）.结论：免疫分型是诊断AML的必备条件,它有助于指导白血病的临床分型诊断、治疗方案的选择及预后的判断.

Immunophenotyping Characteristics of AML and Their Correlation with the Curative Effects

This study was aimed to explore the immunophenotyping characteristics of acute myeloid leukemia （AML） and their correlation with the curative efficacy.The bone marrow or blood samples were collected from 516 patients with newly diagnosed AML,and their immunophenotypes were analyzed by flow cytometry.The results showed that （1） In 516 cases,the ratios of myeloid antigen expression were higher,as follows：MPO 95.0％,CD33 93.0％,CD13 88.8％,CD117 69.4％ ; and the expressions of CD14,CD15,CD64 and CD71 were lower,meanwhile 145 cases were accompanied with lymphocyte antigen expression,the ratios were as follows：CD7 21.5％,CD19 6.0％,CD2 0.78％,CD10 0.58％ and CD20 0.58％ ;the positive expression rate of CD71 in M6 was 100％,and that of CD64 in M5 was the highest（30.2％） ;the overall positive rate of CD34 was 57.8％.（2） After first chemotherapy,the complete remission （CR） rate was 64.7％,CR rate of CD34＋ patients was lower than that of CD34-in M3 group（P =0.019）.The CR rate of CD34 ＋ patients was significantly lower than that of CD34-in non-M3 group （P =0.002）.The CR rate of CD19 ＋ patients was higher than CD19-（P =0.028） ; the CR rate of CD7 ＋ patients was significantly lower than that of CD7-（P =0.002） ; the CR rate of CD71 ＋ patients was lower than that of CD71-（P =0.013） ; the CR rate of MPO ＋ patients was higher than that of MPO-（P =0.015）.Between the CR rate of CD11b,CD13,CD33-positive and-negative group,the difference was not statistically significant （P ＞ 0.05）.It is concluded that the phenotype is a prerequisite for the diagnosis of AML,and can help to guide the clinical typing,selection of treatment protocols and evaluation of prognosis.