125例成人急性髓系白血病免疫表型特点分析

Acute myeloid leukemia by flow cytometry immune phenotypic: A characteristics analysis of 125 cases

  • 摘要: 目的 探讨成人急性髓系白血病(acute myelogenous leukemia,AML)患者的免疫表型特点及临床意义。 方法 2011年5月-2014年6月在河北省涿州市医院和解放军总医院就诊的125例成人AML患者为研究对象,采用多色流式细胞术,以CD45/SSC双参数散点图设门,对其骨髓进行免疫表型检测。 结果 AML患者髓系特异性抗原表达阳性率依次为CD13(90.4%)、CD33(86.4%)、MPO (80.0%)、CD117(73.6%);CD14和CD15主要在M4和M5中表达,CD64和CD15同时强阳性伴HLA-DR高表达,提示M5可能性大;在M3患者中有较强的自发荧光,表达髓系抗原CD13、CD33和MPO,低表达CD34和HLA-DR。造血干/祖细胞标记抗原CD34、HLA-DR、CD38在AML中呈高表达,分别为53.6%、70.4%、71.2%。125例中56例伴有淋系抗原表达,各抗原表达率依次为CD56(25.6%)、CD7(19.2%)、CD19(9.6%)、CD4(7.2%)、CD2(6.4%)。有淋系抗原表达(LymAg+)组表达CD34+比例和肝脾大患者比例明显高于无淋系抗原表达(LymAg-)组(P< 0.01)。伴有CD7+患者完全缓解(CR)率明显低于CD7-患者(P< 0.05),而伴有淋系抗原表达的AML患者CR率(55.6%)与未伴有淋系抗原表达的AML患者CR率(76.2%)差异无统计学意义(P> 0.05)。 结论 AML患者高表达CD13、CD33、MPO,部分患者同时表达髓系、淋系抗原;伴有CD7+表达的患者,化疗后CR率低,预后较差。

     

    Abstract: Objective To investigate immune phenotypic characteristics of adult patients with acute myelogenous leukemia (AML) and its clinical significance. Methods One hundred and twenty-five adult patients with AML admitted to Zhuozhou City Hospital and Chinese PLA General Hospital from May 2011 to June 2014 were enrolled in this study. The immune phenotype in the 125 cases with AML were detected by multicolor flow cytometry with CD45/SSC double parameters scatter plot setting as door. Results The positive rate of myeloid specific antigen expression in AML patients were CD13 (90.4%), CD33 (86.4%), MPO (80.0%), CD117 (73.6%). CD14 and CD15 mainly expressed in M4and M5. CD64 and CD15 also showed strongly positive with high expression of HLA-DR which suggested high possibility of M5. A strong autofluorescence, myeloid antigens CD13, CD33 and low expression of CD34, MPO and HLA-DR were shown in M3patients. Hematopoietic stem/progenitor cell marker antigen CD34, HLA-DR and CD38 were highly expressed in AML with the rate of 53.6%, 70.4% and 71.2%. Of the 125 cases, 56 cases showed leaching antigen expression with the expression rate of CD56 (25.6%), CD7 (19.2%), CD19 (9.6%), CD4 (7.2%), CD2 (6.4%), respectively. The expression of CD34+ ratio and the proportion of hepatosplenomegaly patients in LymAg+ group were significantly higher than LymAg- group (P< 0.05). And the complete remission (CR) rate in patients with CD7+ was significantly lower than CD7- patients (P< 0.05). However, there showed no significant difference in the CR rate of AML patients with lymphoid antigen expression and AML patients without lymphoid antigen expression (55.6% vs. 76.2%, P> 0.05). Conclusion AML patients show high expression of CD13, CD33, MPO, and part of AML patients also show expression of myeloid and lymphoid antigen. Patients with CD7+ expression have low CR ratio with poor prognosis.

     

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