成人急性白血病中CD117与CD34共表达的临床意义

背景与目的:c-kit受体(c-kitreceptor,c-kitR,CD117)是干细胞因子受体。CD117在急性非淋巴细胞白血病(acutenon-lymphoblasticleukemia,ANLL)中高表达,可作为髓系免疫学标记物,对诊断ANLL有一定参考价值。但是,CD117也可在部分急性淋巴细胞白血病(acutelymphoblasticleukemia,ALL)中表达。CD34为造血干(祖)细胞抗原标记物,在ANLL和ALL中均有高表达。本研究旨在探讨CD117和CD34在急性白血病中共表达的临床意义。方法:采用流式细胞术(flowcytometery,FCM)分别检测92例ALL和81例ANLL初诊患者骨髓单个核细胞(BMMNC)CD117的阳性率和阳性细胞水平;比较ALL和ANLL患者CD117/CD34共表达率的差异,并比较ALL患者中CD117和CD117/CD34共表达率的差异。设立20例健康成人为对照组。结果:在ALL和ANLL患者中CD117阳性率分别为15.2%和71.6%,CD117/CD34共表达率分别为5.4%和55.5%,差异有显著性(P<0.001)。ALL患者中CD117表达率和CD117/CD34共表达率分别为15.2%和5.4%,差异有显著性(P=0.029)。结论:CD117可作为急性白血病的MIC分型诊断之髓系免疫学标志,用以协助ANLL的临床诊断;较之CD117表达,CD117/CD34在ALL中的共表达率更低,可籍此协助排除ALL。

Clinical significance of CD117/CD34 co-expression in adult patients with acute leukemia

BACKGROUND & OBJECTIVE: CD117 is highly expressed in acute non-lymphoblastic leukemia (ANLL), and may be used as an immunologic marker of myeloid leukemia. However CD117 is also expressed in some acute lymphoblastic leukemia (ALL) cases. CD34 is highly expressed in both ALL and ANLL. This study was to explore the clinical significance of the co-expression of CD117/CD34 in adult patients with acute leukemia. METHODS: Flow cytometry (FCM) was used to detect the positive rate and expression level of CD117 in bone marrow mononuclear cells (BMMNCs) of 92 patients with ALL and 81 patients with ANLL. The difference between the rates of CD117 expression and CD117/CD34 co-expression in ALL patients and the difference of CD117/CD34 co-expression between ALL and ANLL patients were compared. Twenty healthy individuals were set as controls. RESULTS: The positive rate of CD117 was significantly lower in ALL than in ANLL (15.2% vs. 71.6%, P<0.001). The co-expression rate of CD117/CD34 was significantly lower in ALL than in ANLL (5.4% vs. 55.5%, P<0.001). The positive rate of CD117 was significantly higher than co-expression rate of CD117/CD34 in ALL (15.2% vs. 5.4%, P=0.029). CONCLUSIONS: CD117 may be used as an immunologic marker for acute myeloid leukemia. The co-expression rate of CD117/CD34 is lower than that of CD117 alone in ALL, and therefore, this may be used in the exdusive diagnosis of ALL.