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目的探讨细胞表面分化抗原CD56、CD11b在急性单核细胞白血病(AML-M5)的表达及临床意义。方法采用流式细胞术,G显带技术进行核型分析,双色混合谱系白血病(MLL)基因探针和间期荧光原位杂交(I-FISH)技术,对113例初治成人AML-M5患者进行免疫学和细胞遗传学检测,并回顾分析其临床资料。结果113例患者中CD56表达率28.32%(32例),CD11b表达率73.45%(83例),CD56+患者高表达CD11b(P<0.01),且CD11b的表达水平与CD56呈正相关(P<0.05);113例患者中异常核型患者占48.67%(55例),其中伴11q23异常者占22.12%(25例);I-FISH检测MLL阳性25例;CD56、CD11b共表达的患者比CD56、CD11b双阴性患者外周血白细胞计数、骨髓原始加幼稚细胞数高(P<0.01);前者多合并异常核型,以累及11q23异常常见(P<0.05);较后者容易出现浸润表现、多为难治性白血病患者(P<0.01);且前者完全缓解率及中位生存期均较后者低(P<0.01);CD56+患者与CD11b+患者相比,前者合并异常核型及难治性白血病较后者多(P<0.05),而在外周血白细胞计数、骨髓原始加幼稚细胞数、髓外浸润、完全缓解率及中位生存期均无差别(P>0.05)。结论CD56+、高表达CD11b的AML-M5患者易出现异常核型,以累及11q23/MLL基因异常多见,易合并髓外浸润,且多为难治性患者,预后较差。
Objective To investigate the expression of CD56 and CD11b on acute myeloid leukemia (AML-M5) and its clinical significance. Methods Karyotype analysis, two-color mixed lineage leukemia (MLL) gene probe and interphase fluorescence in situ hybridization (I-FISH) were performed by flow cytometry and G-banding technique in 113 newly diagnosed adult patients with AML-M5 Immunological and cytogenetic testing, and review the clinical data. Results The expression rate of CD56 in CD13b was 28.32% (32 cases), the expression rate of CD11b was 73.45% (83 cases) in CD133 patients, CD11b was highly expressed (P <0.01), and the expression of CD11b was positively correlated with CD56 ; Of 113 patients with abnormal karyotype accounted for 48.67% (55 cases), with 11q23 abnormalities accounted for 22.12% (25 cases); I-FISH detected MLL positive 25 cases; CD56, CD11b co-expression of patients than CD56, CD11b The number of peripheral blood leukocytes and the number of naive naive cells in double-negative patients were higher (P <0.01). The former had more abnormal karyotypes and 11q23 abnormalities (P <0.05), which were more likely to be infiltrative (P <0.01). The complete remission rate and median survival time of the former patients were lower than those of the latter (P <0.01). Compared with CD11b + patients, the former had a combination of abnormal karyotype and refractory leukemia later (P <0.05). There was no difference in peripheral blood leukocyte count, number of primitive bone marrow plus immature cells, extramedullary infiltration, complete remission rate and median survival time (P> 0.05). Conclusions AML-M5 patients with CD56 + and high expression of CD11b are prone to have abnormal karyotype. The abnormality of 11q23 / MLL gene is common, and it is easy to be combined with extramedullary infiltration. Most patients with refractory disease have poor prognosis.