南方医科大学学报

南方医科大学学报 ›› 2020, Vol. 40 ›› Issue (11): 1639-1644.doi: 10.12122/j.issn.1673-4254.2020.11.16

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免疫表型及非髓系分化抗原表达分析： 对急性髓细胞白血病的诊断和预后判定有应用价值

王伟伟，徐元宏   

  • 出版日期:2020-11-20 发布日期:2020-11-23

Analysis of immunophenotypes and expressions of non-myeloid antigens in acute myeloid leukemia

  • Online:2020-11-20 Published:2020-11-23

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摘要： 目的 探讨急性髓细胞白血病（AML）免疫表型和非髓系分化抗原表达特征及其临床应用价值。方法 采用 BDFACSCalibur流式细胞仪对109例AML患者进行免疫表型检测，分析AML免疫表型、非髓系分化抗原表达的特点及与预后疗效完全缓解（CR）率的关系。结果 免疫表型显示AML细胞髓系分化抗原阳性率由高到低依次为CD13、CD117、CD33、MPO、CD15，其中CD117、CD13、CD33、MPO阳性率差异无统计学意义（P>0.05），并且均高于CD15阳性率（P<0.05）；AML细胞非髓系分化抗原CD9、CD200、CD56、CD7阳性率依次降低，均高于CD25、CD19、CD2、CD10、CD4、CyCD79a、CyCD3阳性率（P<0.05）；109例AML中CD7、CD34、CD56、CD25呈阳性的患者CR率均低于阴性患者（P<0.05）；MPO、CD19呈阳性的患者CR率均高于阴性患者（P<0.05）；伴AML1-ETO阳性表达的15例AML-M2b患者中CD56阳性组1疗程CR率低于CD56阴性组，CD56阳性组1年内复发率高于CD56阴性组（P<0.05）。结论 免疫表型和非髓系分化抗原表达分析对AML的诊断及预后判定有重要临床意义，是AML诊疗的主要依据之一。

关键词: 急性髓细胞白血病, 免疫表型, 非髓系分化抗原, 流式细胞仪

Abstract: Objective To investigate the characteristics of immunophenotypes and expressions of non-myeloid differentiation antigens in acute myeloid leukemia (AML) and their value in diagnosis and prognostic evaluation of AML. Methods We examined the immunophenotypes of 109 patients with AML using BD FACSCalibur flow cytometry and analyzed the association of the immunophenotypes and expressions of non-myeloid differentiation antigens with the prognosis and complete remission (CR) rate of the patients. Results Immunophenotype analysis showed that the positivity rates of the myeloid differentiation antigens of AML cells decreased in the order of CD13, CD117, CD33, MPO and CD15; the positivity rates of CD117, CD13, CD33 and MPO did not differ significantly (P>0.05) and were all significantly higher than that of CD15 (P<0.05). The positivity rates of AML cell non-lineage antigens CD34, CD38, HLA-DR, and CD123 did not differ significantly (P>0.05). The positivity rates of non-myeloid differentiation antigens decreased in the order of CD9, CD200, CD56 and CD7 in AML cells and were all significantly higher than those of CD25, CD19, CD2, CD10, CD4, CyCD79a and CyCD3 (P<0.05). Among the 109 AML patients, the CR rates of patients positive for CD7, CD34, CD56 and CD25 were significantly lower than those negative for these antigens (P<0.05); the CR rates were significantly higher in patients positive for MPO and CD19 than in the negative patients (P<0.05). Among the 15 AML-M2b patients with AML1-ETO positivity, the CR rate following a single treatment course was significantly lower in patients positive for CD56 than in CD56-negative patients, and CD56-positive patients also had a significantly higher relapse rate within 1 year (P<0.05). Conclusion Immunophenotyping and analysis of non-myeloid differentiation antigens can be of great clinical significance for the diagnosis and prognostic evaluation of AML, and serve also as one of the important bases for the diagnosis and treatment of AML.

Key words: acute myeloid leukemia, immunophenotypes, non-myeloid differentiation antigens, flow cytometry