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目的 :研究CD5 6 +急性髓系白血病 (AML)血液学特征及临床意义。方法 :流式细胞计数仪检测白血病细胞分化抗原的表达 ;RT PCR检测EBV mRNA ;电镜及免疫电镜观察超微结构 ;回顾性分析初诊时血液学特点、临床表现及对化疗的反应。结果 :CD5 6表达率为 30 .6 2 %(79 2 5 8) ;CD5 6 +AML中未见EBV感染 ;电镜及免疫电镜发现CD5 6 +AML细胞核中存在 1— 2团絮状结构 ;CD5 6的表达与年龄、性别、WBC、Hb、BPC、BM中白血病细胞数、CR率及CR期无关 (P值分别为 0 .12 8,0 .877,0 .181,0 .86 6 ,0 .6 2 9,0 .40 7,0 .998,0 .0 96 ) ;与较多的髓外侵润(77.78%对 6 1.11%,P =0 .0 19)、CD34表达 (6 6 .6 7%对 46 .48%,P =0 .0 3)、P170表达 (5 1.79%对 34 .94%,P =0 .0 48)及较短的生存期有关 (中位数 ,11.5个月对 18个月 ;P值 0 .0 478)。结论 :CD5 6 +AML是一种特殊类型的白血病 ,预后较差 ,应进一步分型并针对性治疗。
Objective: To study the hematological features and clinical significance of CD5 6 + acute myeloid leukemia (AML). Methods: Flow cytometry was used to detect the expression of differentiation antigen in leukemia cells; RT PCR was used to detect EBV mRNA; Electron microscopy and immunoelectron microscopy were used to observe the ultrastructure; The characteristics of hematology, clinical manifestations and response to chemotherapy were analyzed retrospectively. Results: The expression rate of CD5 6 was 30.62% (79 2 58); no EBV infection was found in CD5 6 + AML; Electron microscopy and immunoelectron microscopy revealed the presence of 1-2 flocculent structures in the nucleus of CD5 6 + AML; CD5 The expression of 6 was not associated with age, gender, WBC, Hb, BPC, leukemia cell number, CR rate and CR period in BM (P values were 0.112, 0.847, 0.181, 0.86, 0, respectively). .6 2 9,0 .40 7,0 .998,0 .0 96 ); with more extramedullary infiltration (77.78% vs 6 1.11%, P =0. 0 19), CD34 expression (6 6 . 6 7% vs 46.48%, P =0. 0 3), P170 expression (5 1.79% vs 34.94%, P =0. 0 48) and shorter survival (median, 11.5 Month to 18 months; P value 0. 0 478). Conclusion: CD5 6 +AML is a special type of leukemia with poor prognosis. It should be further typed and targeted therapy.