CD133在急性白血病中的表达及其意义

目的　探讨CD133(AC133)在急性白血病 (AL)中的表达及其意义。方法　采用三色荧光流式细胞术测定 76例AL患者白血病细胞膜上CD133的表达 ;采用半定量逆转录 聚合酶链反应(RT PCR)方法测定CD133mRNA的表达。结果　①正常对照和AL患者的CD133mRNA表达与CD133蛋白表达相一致 ,AL患者CD133表达水平显著高于正常对照。②AL患者CD133及CD133mRNA高表达阳性率分别为 4 2 .1%和 4 6 .1%。急性髓系白血病 (AML)M3 患者CD133均高表达阴性 ,AML和急性淋巴细胞白血病 (ALL)的CD133高表达率分别为 4 3.4 %和 38.1% ,差异无显著性。AML M4CD133高表达阳性率显著高于其它AML亚型 ,而T ALL和B ALL的CD133高表达率分别为 2 0 .0 %和 4 3.7% ,差异也无显著性。③AML患者骨髓细胞CD133表达与CD34、HLA DR显著相关 ,ALL患者骨髓细胞CD133表达与CD34无关。④CD133表达与细胞或分子遗传学异常、发病时外周血白细胞数、乳酸脱氢酶水平、多药耐药基因 (mdr1)表达及年龄等预后因素无显著相关。⑤CD133高表达阳性组完全缓解 (CR)率及总反应 (OR)率低于高表达阴性组 ,但仅有CD34/CD133共高表达阳性组CR率低于阴性组 (44 .4 %vs71.4 % ,P <0 .0 5 ) ,差异有显著性。结论　AL患者骨髓细胞CD133表达高于正常对照 ;检测CD133表达可能有

The expression of CD133 in acute leukemia and its clinical significance

OBJECTIVE: To evaluate the expression of CD133 and its clinical significance in acute leukemia (AL) patients. METHODS: The expression of CD133 and CD133 mRNA in leukemic blasts from 76 AL patients were detected by three-color flow-cytometry and hemi-quantitative RT-PCR respectively. RESULTS: (1) CD133 mRNA expression was highly correlated with CD133 expression in both of normal donors and AL patients groups. The expression of CD133 in AL patients was significantly higher than that in control group (P < 0.01). (2) The positive rates of CD133 and CD133 mRNA in AL group were 42.1% (32/76) and 46.1% (35/76) respectively. There was no significant difference in CD133 expression between AML-M(3) and normal control, AML and ALL, as well as T-ALL and B-ALL. The expression of CD133 in AML-M(4) were significantly higher than those in other AML subtypes (81.8% vs 43.7% and 81.8% vs 46.9% at CD133 and CD133 mRNA level, respectively, P < 0.01). (3) The expression of CD133 in AML was significantly correlated with the expression of CD34 and HLA-DR (P < 0.001). (4) The expression of CD133 had no relationship with the clinical prognostic factors such as cytogenetic or molecular aberrations, WBC counts, LDH, mdr1 expression and age. (5) There was a trend toward lower CR rate in CD133(+) cases, but only CD34/CD133(+) double positive cases had significant lower CR rate than that of negative ones (44.4% vs 71.4%, P < 0.05). CONCLUSIONS: AL had significantly higher CD133 expression compared to normal control. The detection of CD133 expression might help to identify AL type and predict therapeutic outcomes. Co-expression of CD133/CD34 might convey adverse prognosis of AL.