急性髓系白血病患者体内solGM-Rα的表达研究_医学论文.docVIP

急性髓系白血病患者体内solGM-Rα的表达研究_医学论文 急性髓系白血病患者体内solGM-Rα的表达研究_医学论文 作者：肖溶，张日，王友良，朱子玲，陈涛，杨建和 【摘要】 为了研究GM-CSF可溶性α受体solGM-Rα在急性髓系白血病患者体内的表达，探讨其与AML患者临床特征的相关性及临床意义，以酶联免疫吸附试验ELISA法检测66例初治AML患者血浆标本solGM-Rα的含量，并与AML患者MIC检测结果及临床资料相结合，进行综合分析。结果表明：AML患者血浆solGM-Rα浓度明显高于正常对照，在M3型最低 (3897.75±2651.43 pg/ml)，而在M5型最高(9990.92±6325.43 pg/ml)（0.05）。solGM-Rα增高者多见于MIC的M5型，后者常伴有外周血白细胞增多、骨髓粒系原始细胞增多及CD34、CD95和CD116抗原高表达等特性。结论：solGM-Rα升高可能提示预后不良，GM-CSF及其受体系统介导的靶向杀伤值得进一步研究。 【关键词】 急性髓系白血病 　　Expression of Soluble GM-CSF-Rα in Patients with Acute Myeloid Leukemia 　　Abstract To evaluate soluble GM-CSF-Rα expression in patients with acute myeloid leukemia (AML) and its clinic significance，plasma concentration of solGM-Rα in de novo 66 patients with AML was detected by enzyme-linked immuno-sorbent assay，and the relationship between solGM-Rα levels and various clinical parameters was analyzed.The result showed that the levels of solGM-Rα in plasma of patients with AML were significantly higher than that in plasma of normal controls the lowest level of solGM-Rα was found in plasma of patients with AML-M3 (3897.75±2651.43 pg/ml)，the highest level of solGM-Rα was observed in plasma of patients with AML-M5 (9990.92±6325.43 pg/ml).Patients with high level of solGM-Rα were generally accompanied with a distinct clinical picture，including higher counts of white blood cell and myeloid precursors，as well as higher expression of CD34，CD95 and CD116 antigen.It is concluded that the high level of solGM-Rα in plasma of patients may suggest AML poor prognosis and play a role in pathogenesis of leukemia，the GM-CSF and its receptor solGM-Rα needs further study. 　　Key words acute myeloid leukemia GM-CSF solGM-Rα 　　粒细胞-巨噬细胞集落刺激因子（granulocyte macrophage colony-stimulating factor，GM-CSF）可通过自分泌及旁分泌机制影响急性髓系白血病（acute myeloid leukemia，AML）细胞集落的形成，在高度异质性的AML各型发生发展中可能具有重要作用［1］。GM-CSF 的可溶性α受体(solGM-Rα)可作为诱导受体竞争结合GM-CSF而下调其信号传导，并能直接拮抗GM-CSF的功能。我们对AML患者体内solGM-Rα的表达进行了相关研究，试图探寻其作为GM-CSF的内源性调节因子在AML发病中的作用。 　　材料和方法 　　病例及临床情况 　　66例MIC确诊的