CD56在正常核型急性髓系白血病患者中的表达及临床意义

目的分析正常核型急性髓系白血病(cytogenetically normal acute myeloid leukemia,CN-AML)患者骨髓白血病细胞中CD56表达情况,探讨CD56对CN-AML患者预后的影响。方法76例初诊CN-AML患者,应用流式细胞术检测骨髓白血病细胞中CD33、CD13、CD123、CD38、人类白细胞抗原(human leukocyte antigen,HLA)-DR、CD19、CD56、CD64、CD7、CD4、CD11b、CD14、CD15阳性表达,并均在评估病情后给予蒽环类药物联合阿糖胞苷标准诱导方案化疗。依据CD56表达是否≥20%,将76例患者分为CD56阳性组32例和CD56阴性组44例,比较2组临床特征及骨髓白血病细胞免疫表型特征、完全缓解率,随访1年观察复发率、总生存率和无事件生存率。结果CD56阳性组年龄[(50.9±16.1)岁]大于CD56阴性组[(38.56±15.2)岁](P<0.05),急性髓系白血病-M5亚型比率(31.3%)高于CD56阴性组(4.5%)(P<0.05),CD4、CD11b、CD14阳性表达率(43.8%、34.4%、28.1%)高于CD56阴性组(15.9%、13.6%、2.3%)(P<0.05);CD56阳性组与CD56阴性组白细胞计数、血小板计数、血红蛋白、乳酸脱氢酶、骨髓原始细胞比率、外周血原始细胞比率及CD33、CD13、CD123、CD38、HLA-DR、CD19、CD56、CD64、CD7、CD15阳性表达率比较差异均无统计学意义(P>0.05)。CD56阳性组完全缓解率(65.6%)、部分缓解率(18.8%)、复发率(47.6%)与CD56阴性组(68.2%、18.2%、40.0%)比较差异均无统计学意义(P>0.05),CD56阳性组1年总生存率(53.1%)和无事件生存率(50.0%)均低于CD56阴性组(77.3%、79.5%)(P<0.05)。结论CD56阳性表达可能提示CN-AML患者预后不良。

CD56 expression and its clinical significance in patients with cytogenetically normal acute myeloid leukemia

Objective To analyze the expression of CD56 in bone marrow blasts of cytogenetically normal acute myeloid leukemia(CN-AML),and to investigate the influence of CD56 on the prognosis of CN-AML patients.Methods The positive expressions of CD33,CD13,CD123,CD38,human leukocyte antigen(HLA)-DR,CD19,CD56,CD64,CD7,CD4,CD11 b,CD14 and CD15 in bone marrow blasts were detected by flow cytometry in 76 newly diagnosed CN-AML patients.After assessment,all patients were treated with standard anthracyclines and cytarabine regimens for induction therapy.According to whether the expression of CD56 was≥20%,the patients were divided into CD56+group(n=32)and CD56-group(n=44).The clinical data,immunophenotypic characteristics and complete remission rates were compared between two groups.All patients were followed up for one year to observe the relapse rate,one-year overall survival rate and event-free survival rate.Results The patients in CD56+group((50.9±16.1)years)were older than the patients in CD56-group((38.56±15.2)years)(P<0.05).The proportion of FAB-M5 subtype was higher in CD56+group(31.3%)than that in CD56-group(4.5%)(P<0.05).The positive rates of CD4,CD11 b and CD14 were higher in CD56+group(43.8%,34.4%,28.1%)than those in CD56-group(15.9%,13.6%,2.3%)(P<0.05).There were no significant differences in white blood cell count,hemoglobin,platelet count,lactate dehydrogenase,blast counts in the bone marrow and in the peripheral blood,and the expression rates of CD33,CD13,CD123,CD38,HLA-DR,CD19,CD56,CD64,CD7 and CD15 between two groups(P>0.05).The complete remission rate,partial remission rate and relapse rate showed no significant differences between CD56+group(65.6%,18.8%,47.6%)and CD56-group(68.2%,18.2%,40.0%)(P>0.05).The one-year overall survival rate and event-free survival rate were lower in CD56+group(53.1%,50.0%)than those in CD56-group(77.3%,79.5%)(P<0.05).Conclusion The positive expression of CD56 may predict a poor prognosis in patients with CN-AML.