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目的检测白细胞介素-3受体α(IL-3Rα)在急性髓性白血病(AML)患者原代骨髓细胞中的表达情况,并探讨其临床意义。方法采用流式细胞仪(FACS)检测天津医科大学总医院2008年3月至2009年1月收治的62例AML患者及12名正常人原代骨髓CD34+CD38-细胞中IL-3Rα(CD123+)阳性细胞的比例,了解IL-3Rα蛋白水平表达情况;同时采用逆转录-聚合酶链反应(RT-PCR)检测IL-3RαmRNA在骨髓单个核细胞(BMMNC)的表达情况;进而分析IL-3Rα表达情况与AML病情的相关性。结果33例初诊和复发AML患者CD34+CD38-CD123+/CD34+CD38-及IL-3RαmRNA RT-PCR均显著高于对照组(P<0.05);29例缓解AML与对照组比较差异也具有统计学意义(P<0.05),且低于初治、复发组(P<0.05)。动态随访了13例AML患者,其中6例初发患者缓解者CD34+CD38-CD123+/CD34+CD38-及IL-3RαmRNA RT-PCR均显著降低(P<0.05);3例缓解后复发者显著上升(P<0.05);4例患者处于缓解状态,CD34+CD38-CD123+/CD34+CD38-无显著表达,RT-PCR未检测到IL-3Rα。结论在初治和复发AML患者,IL-3Rα异常过度表达;AML缓解期IL-3Rα表达降低;提示IL-3Rα过度表达与AML克隆负荷消长相关;临床上可检测该指标以评价AML疗效并判断预后、监测复发。
Objective To detect the expression of interleukin-3 receptor α (IL-3Rα) in primary myeloid cells of patients with acute myeloid leukemia (AML) and to investigate its clinical significance. Methods Flow cytometry (FACS) was used to detect IL-3Rα (CD123 +) in 62 AML patients and 12 normal human primary bone marrow CD34 + CD38- cells from March 2008 to January 2009 in Tianjin Medical University General Hospital. The expression of IL-3Rα protein was detected by RT-PCR. The expression of IL-3Rα mRNA in bone marrow mononuclear cells (BMMNC) was detected by reverse transcription-polymerase chain reaction (RT-PCR) Correlation between the condition and AML. Results The RT-PCR of CD34 + CD38-CD123 + / CD34 + CD38- and IL-3RαmRNA in 33 newly diagnosed and relapsed AML patients was significantly higher than that in the control group (P <0.05). The difference between the 29 AML patients and the control group was also statistically significant Significance (P <0.05), and lower than the initial treatment, recurrence group (P <0.05). Thirteen patients with AML were followed up dynamically. RT-PCR of CD34 + CD38-CD123 + / CD34 + CD38- and IL-3RαmRNA was significantly decreased in 6 patients with initial relapse (P <0.05) (P <0.05). Four patients were in remission, but no significant expression of CD34 + CD38 + CD123 + / CD34 + CD38- was detected. No IL-3Rα was detected by RT-PCR. CONCLUSIONS: IL-3Rα is overexpressed in newly diagnosed and relapsed AML patients, IL-3Rα expression is decreased in AML remission stage, which indicates that IL-3Rα overexpression correlates with the growth of AML clones, and clinically it can be used to evaluate the therapeutic effect of AML Prognosis, monitoring recurrence.