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目的探讨白细胞分化抗原96(CD96)蛋白表达在急性白血病患儿预后评估中的临床价值。方法随机选择2015年3月至2017年4月常德市第一人民医院收治的急性白血病患儿107例,其中男性65例,女性42例;年龄3个月~12岁,中位年龄7.5岁。急性髓系白血病(AML)53例,急性淋巴细胞白血病(ALL)54例。采用流式细胞仪检测107例急性白血病患儿白血病干细胞(LSC)表面分子CD96蛋白的表达情况,同时收集患儿血常规、免疫指标等临床资料并进行回顾性分析。结果 CD96蛋白表达阳性在AML患儿中表达例数显著高于ALL患儿[34例(64.15%)vs 13例(24.07%),差异有显著统计学意义(P<0.01)。CD96蛋白表达阳性的患儿初次化学治疗完全缓解率明显低于CD96蛋白表达阴性的患儿[12例(32.43%)vs 35例(72.92%)],且化学治疗后复发率、髓外浸润率明显高于CD96蛋白表达阴性的患儿(75.68%vs 35.42%,27.03%vs 6.25%),差异有显著统计学意义(P<0.01)。结论 CD96蛋白表达阳性的急性白血病患儿预后较差,该蛋白在急性白血病预后判断中具有较高的应用价值。
Objective To investigate the clinical value of the expression of leukocyte differentiation antigen 96 (CD96) in the prognosis of children with acute leukemia. Methods A total of 107 children with acute leukemia, including 65 males and 42 females, were selected randomly from March 2015 to April 2017 in Changde First People’s Hospital. Their ages ranged from 3 months to 12 years. The median age was 7.5 years. 53 cases of acute myeloid leukemia (AML), 54 cases of acute lymphoblastic leukemia (ALL). Flow Cytometry was used to detect the expression of CD96 protein on 107 leukemia stem cells (LSCs) in children with acute leukemia. The clinical data of blood routine and immune index were collected and analyzed retrospectively. Results The positive expression rate of CD96 protein in children with AML was significantly higher than that in ALL children [34 (64.15%) vs 13 (24.07%), the difference was statistically significant (P <0.01). The complete remission rate of primary chemotherapy in children with positive CD96 expression was significantly lower than that in patients with negative CD96 protein expression (12 cases (32.43%) vs 35 cases (72.92%)]. The recurrence rates after chemotherapy, extramedullary infiltration rate (75.68% vs 35.42%, 27.03% vs 6.25%). The difference was statistically significant (P <0.01). Conclusion The prognosis of children with acute leukemia with positive CD96 protein expression is poor. The protein has high value in the prognosis of acute leukemia.