白血病细胞表面乙酰肝素酶及其相关蛋白的表达

 目的　观察白血病细胞表面乙酰肝素酶（HPA）及其相关蛋白表达，研究白血病细胞表面止血平衡改变。方法　研究组为白血病40例，对照组为缺铁性贫血患者20例。流式细胞术检测骨髓白血病细胞表面HPA、组织因子（TF）、组织因子途径抑制物（TFPI）、尿激酶纤溶酶原激活物受体（uPAR）的表达。结果　与对照组相比，白血病患者骨髓中白血病细胞表面HPA、TF、UPAR的表达均显著升高（均P＜0.05），TFPI的表达与对照组相比差异无统计学意义 （P＞0.05）。初发白血病中急性髓系白血病（AML）组表达高于慢性粒细胞白血病（CML）、急性淋巴细胞白血病（ALL）、慢性淋巴细胞白血病（CLL）组（均P＜0.05）。其中TF的表达AML组与CML、ALL及CLL组相比t值为2.463、2.179、2.276，P值为0.021、0.037、0.028；UPAR的表达AML组与CML、ALL及CLL组相比t值为2.637、2.402、2.095，P值为0.015、0.025、0.041；HPA的表达AML组与CML、ALL及CLL组相比t值为2.548、2.425、2.412，P值为0.017、0.023、0.019。AML中 M3、M4、M5的表达较其他类型组高（均P＜0.05），3者之间比较差异无统计学意义 （均P＞0.05）。结论　白血病细胞表面HPA、TF、UPAR表达增高；不同类型白血病表达水平不同，急性白血病，尤其是AML中 M3、M4、M5表达更加明显。提示TF、UPAR、HPA影响白血病细胞表面止血平衡，不同类型白血病细胞表面止血平衡改变不同。

Expression of heparanase and its coagulation proteins on the surface of leukemic cells

Objective To explore whether the expression level of heparanase (HPA) and its coagulation proteins on leukemic blast membrane could determine the hemostatic balance on the surface of leukemia cells.Methods Forty patients of leukemia were studied,and 20 patients with iron dificient anemia as the control group.Expression of tissue factor (TF),heparanase (HPA),tissue factor pathway inhibitor (TFPI),and urokinase plasminogen activator receptor (UPAR) on leukemic blast surfaces were analyzed by flowcytometry.Results The expression of TF,UPAR,and HPA in AML,ALL,CML,CLL and CRAL groups were significantly higher compared with the control group (t =.3.289,3.507,2.701,P ＜0.05; t =2.498,0.802,3.090,P ＜0.05; t =2.642,3.308,2.696,P ＜0.05; t =3.417,3.434,2.382,P ＜0.05; t =2.193,2.272,2.263,P ＜0.05).There were no significantly differences between the leukemic cell expression of TFPI and the control group (P ＞0.05).Expression of TF,UPAR,HPA in AML patients were significantly higher than ALL,CML and CLL groups (t =2.463,2.179,2.276,P ＜0.05; t =2.637,2.402,2.095,P ＜0.05; t =2.548,2.425,2.412,P ＜0.05).The levels of TF,UPAR and HPA in M3,M4 and M5 patients were higher than that of M1,M2 groups (P ＜0.05).There were no significantly differences among M3,M4 and M5 (P ＞0.05).Conclusions These results suggest that TF,UPAR and HPA are predominately expressed on leukemic blast surface,particularly in M3and M4,5 subtypes.The expression of coagulation proteins on blast membrane might determine the hemostatic balance on the surface of leukemia cells.