论文部分内容阅读
背景与目的:CD117是c-k it受体(c-k it receptor,c-k it R)膜外区分子表面抗原标志。研究表明,CD117在急性非淋巴细胞白血病(acute non lymphob lastic leukem ia,ANLL)高表达,可作为髓系白血病膜抗原标志物,对诊断ANLL有临床参考价值。但是,CD117的表达与ANLL化疗疗效的关系如何及其表达是否可作为判断ANLL预后的指标等问题尚无明确结论。本文旨在研究成人ANLL中CD117的表达与化疗疗效的关系,探讨CD117的表达与ANLL预后的关系。方法:采用流式细胞术(flow cytom etery,FCM)分别检测初诊的38例急性淋巴细胞白血病(acute lymphob lastic leukem ia,ALL)和81例ANLL成人患者骨髓单个核细胞(BMMNC)CD117表达的阳性率和阳性水平。设立20例健康成人为对照组。ANLL的M3亚型采用全反式维甲酸(ATRA)治疗;其他亚型均采用DA方案或/和HA方案治疗。分析ANLL各亚型CD117表达及其化疗的完全缓解率(CR)。根据CD117表达的阳性与否,将ANLL分为CD117阳性(+)组和CD117阴性(-)组,比较两组ANLL的CR。结果:对照组、ALL和ANLL CD117阳性表达率分别为0、13%(5/38)和70%(57/81),ANLL组CD117阳性率明显高于对照组和ALL组(P=0.000)。ANLL组CD117阳性细胞水平与对照组和ALL组比较均有显著差异(P=0.000)。CD117阳性细胞水平高低依次为M3/M1、M2/M6/M4、M5;CR高低依次如下:M3:80%(8/10)、M1~M2:73.9%(31/42)、M4~M5:57.9%(11/19)。CD117(+)组和CD117(-)组CR率分别为51%(29/57)和67%(16/24)(P=0.192),两组CR率无统计学意义的差异。结论:CD117可作为急性白血病髓系免疫学标记之一。ANLL患者CD117阳性与否及其阳性水平的高低与化疗CR率之间没有必然的因果关系。CD117表达不是判断ANLL的疗效及其长期存活率的独立指标。
BACKGROUND & OBJECTIVE: CD117 is a molecular marker of surface antigen in the extracellular domain of c-kit receptor (c-kit receptor). Studies have shown that CD117 is highly expressed in acute non-lymphocytic leukemia (ANLL) and can be used as a marker of myeloid leukemia membrane antigens, which has clinical value in the diagnosis of ANLL. However, the relationship between the expression of CD117 and the efficacy of ANLL chemotherapy and whether its expression can be used as an indicator to judge the prognosis of ANLL and so there is no clear conclusion. This article aims to study the relationship between the expression of CD117 in adult ANLL and chemotherapeutic efficacy and to explore the relationship between the expression of CD117 and the prognosis of ANLL. Methods: The positive expression of CD117 on bone marrow mononuclear cells (BMMNC) from 38 newly diagnosed acute lymphoblastic leukemia (ALL) and 81 patients with ANLL was detected by flow cytometry (FCM) Rate and positive level. Twenty healthy adults were set as the control group. ANLL M3 subtype with all-trans retinoic acid (ATRA) treatment; other subtypes were treated with DA regimen or / and HA regimen. The expression of CD117 in ANLL subtypes and the complete response rate (CR) of chemotherapy were analyzed. ANLL was divided into CD117 positive (+) group and CD117 negative (-) group according to the positive expression of CD117, CR of the two groups were compared. Results: The positive rates of CD117 in control group, ALL and ANLL were 0,13% (5/38) and 70% (57/81) respectively. The positive rate of CD117 in ANLL group was significantly higher than that in control group and ALL group (P = 0.000) . The level of CD117 positive cells in ANLL group was significantly different from that in control group and ALL group (P = 0.000). The levels of CD117 positive cells were M3 / M1, M2 / M6 / M4 and M5 in sequence: M3: 80% (8/10), M1 ~ M2: 73.9% (31/42) 57.9% (11/19). The CR rates in CD117 (+) and CD117 (-) groups were 51% (29/57) and 67% (16/24), respectively (P = 0.192). There was no significant difference in CR rates between the two groups. Conclusion: CD117 can be used as one of myeloid immunological markers of acute leukemia. There is no necessary causal relationship between the positive or negative level of CD117 and the CR rate in patients with ANLL. The expression of CD117 is not an independent indicator to judge the curative effect of ANLL and its long-term survival rate.