CD56在急性单核细胞白血病细胞表达的意义

目的：探讨CD56分子对急性髓性白血病（AML）之急性单核细胞白血病（M5）细胞生物学及临床特征的影响.方法：应用G显带技术及流式细胞仪对45例M5患者分别进行核型及免疫表型检测，并回顾分析其临床资料.结果：45例患者中CD56表达阳性17例（37.78%），其中正常核型2例（11.76%），异常核型15例（88.24%），以8号三体和11q23异常易见（分别占23.53%，29.41%）;伴CD56抗原表达的患者高表达CD11b，CD14（P＜0.01，P＜0.05），外周血白细胞计数偏高，骨髓及外周血中原始和幼稚细胞百分比明显升高（P＜0.05），较多出现髓外浸润，尤其以淋巴结肿大（P＜0.05）和肝脾肿大（P＜0.05）明显，伴二系以上受累也明显高于对照组（P＜0.05），而中枢神经系统及皮肤浸润与对照组比较差异无统计学意义（P＞0.05），同时伴CD56阳性的患者出现较低的完全缓解率及较短的生存期（P＜0.05）.结论：CD56阳性的M5患者易出现异常核型，高表达CD11b，CD14，预后较差。

Significance of CD56 antigen expression in acute monocytic leukemic (AML-M5) cells

Objective:To investigate the cytobiological and clinical characteristic impact of CD56 antigen in acute monocytic leukemia.Method:A total of 45 cases of de novo adult AML M_5 was identified. Karyotypes were analyzed by G-banding. Immunofluresence analysis by flow cytometry was perforemed to detect the immunophenotype of the leukemic cells in all cases. Meanwhile, clinical informations of these cases were studied retrospectively.Result:Of 45 cases with AML-M_5, we found 17( 37.78 %) with CD56 expression, 2( 11.76 %) with normal karyotype and 15( 88.24 %) with aberrant karyotype. 11q23 aberrations and trisomy 8 were common in those with aberrant karyotype. CD 11b and CD 14 were highly expressed in M_5 patients with CD56+ ( P < 0.05 , P < 0.05 , respectively). These patients had special clinical characteristics: high WBC counts in peripheral blood ( P < 0.01 ); high blast and progenitor cells in bone marrow and peripheral blood ( P < 0.01 ); frequent extramedullary infiltration, especially enlargement of the lymph nodes( P < 0.05 ), hepatosplenomegaly( P < 0.05 ) and involvement of above two systems ( P < 0.05 ); low complete remission and short disease-free survival( P < 0.05 ).Conclusion:Aberrant karyotype is often detected in M_5 patients with CD56+, and high expression of CD 11b and CD 14 are also observed frequently. At the same time, these cases are identified with poor prognosis.