急性髓性白血病分化抗原表达与临床表现及疗效的关系.DOCVIP

临床医学论文-急性髓性白血病分化抗原表达与临床表现及疗效的关系 【摘要】? 目的 探讨急性髓性白血病(AML)分化抗原表达与临床表现和疗效的关系。 方法 用流式细胞术检测111例AML细胞的分化抗原,分析其与临床表现和疗效的关系。 结果 (1)髓系抗原在AML中阳性表达率依次为89.2%(CD13),79.3%(CD33),50.5%(CD34),37.8%(CD15),36.9%(HLA-DR),21.6%(CD14),CD13及CD33在AML各亚型中均有较高的阳性表达率。CD14在M5阳性表达率较高,HLA-DR在M3为阴性。淋系相关抗原在AML中的表达以CD7为主。(2)AML患者中CD15表达与外周血白细胞数以及血幼稚细胞百分比相关;CD7+AML患者更常肝脾肿大。(3)CD34-组CR率高于CD34+组,且达完全缓解（CR）时间少于CD34+组。CD7-组CR率高于CD7+组,但达CR时间两组间无明显差别。CD19+组CR率高于CD19-组,而达CR时间无明显差别。CD7+CD34+组CR率少于非CD7+CD34+组,有显著差别。 结论 CD7，CD19及CD34表达与AML的临床表现和疗效有一定关系,可作为AML预后判断的指标。 【关键词】? 急性白血病; 抗原; 临床表现; 预后 　??? ABSTRACT:? Objective? To analyze expression of differentiation antigen of acute myeloid leukemia(AML) and its relationship with clinical characteristics and prognosis.? Methods? The expression of differentiation antigen of 111 cases of AML was investigated by flow cytometry assay.?Results?(1)The frequency of antigen expression on blast cells in AML were 89.2%(CD13), 79.3%(CD33), 50.5%(CD34), 37.8%(CD15), 36.9%(HLA-DR) and 21.6%(CD14) respectively. HLA-DR was negative in M3 patients.?CD7, one of the lymphoid antigens, was found to be expressed frequently in the AML blast cells.?(2)The expression of CD15+ of AML was related with the blasts count and white blood cell count.?Those patients with CD7+ usually had spleno-hepatomegaly.?(3)The CR rate in the cases with CD34+ was significantly lower than those with CD34-, but the time to CR was longer.?CR rate in CD7+ cases was significantly lower than those with CD7-.?However, patients with CD19- had lower CR rate than those with CD19+.?But interestingly, CR rate in cases with CD7+CD34+ was significantly lower than those with CD7-CD34-.?Conclusion?CD7, CD19 and CD34 are relating with the clinical characteristics and prognosis of AML, and could be the one of important factors in predicting prognosis. ??? KEY WORDS:? acute? leukemia; immunophenotype; prognosis; clinical presentations ??? 急性髓细胞白血病(AML)是一种高度异质性的恶性血液病,临床表现多种多样,抗原表达不一,部分病例诊断分型困难,给AML临床诊治带来一定的困难。随着分子生物