儿童急性髓系白血病免疫表型特点分析
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摘要
目的:分析儿童急性髓系白血病(AML)免疫表型特征,探讨其临床意义。方法:采用四色流式细胞术CD45/SSC双参数散点图设门方法,对127例儿童AML患者幼稚细胞进行免疫表型检测,对抗原表达情况进行分析。结果:在127例儿童急性髓系白血病患者中,髓系特异性抗原CD33、CD13和CD117的表达最常见,分别达95.3%、90.6%、90.6%。造血干/祖细胞抗原CD34、HLA-DR、CD38阳性率分别达53.5%、71.6%和97.6%。有65.4%的病例伴有淋系抗原的表达,其中以CD56的表达最常见占38.6%,其次为CD7占21.3%。有淋系抗原表达(LymAg~+)患者早期抗原CD34和HLA-DR抗原表达阳性率明显高于无淋系抗原表达(LymAg~-)患者(P<0.05)。结论:免疫分型对儿童AML的诊断和不同亚型鉴别具有重要意义。
Objective: To investigate the immune phenotypic characteristics of childhood acute myeloid leukemia( AML) and its clinical significance. Methods: The immune phenotype in 127 cases with childhood AML were detected by four color flow cytometry with CD45/SSC double parameters scatter plot setting as door,and then the antigentic expressions were analysed. Results: In 127 patients with childhood AML,the Myeloid antigen of CD33,CD13,CD117 showed highly expressed. The positive rates were 95. 3%,90. 6%,90. 6%. Hematopoietic stem/progenitor cell marker antigen CD34,HLA-DR and CD38 were expressed in AML with the rates of 53. 5%,71. 6% and 97. 6%. The lymphoid antigen was positive in 65. 4% of cases,with the highest frequency of CD5 6( 3 8. 6 %) followed by CD7( 21. 3%). The expression of CD34~+and HLA-DR~+patients in LymAg~+group were significantly higher than LymAg~-group( P < 0. 05). Conclusion: The immunophenotyping played an important role in diagnosis and classification of childhood AML.
Objective: To investigate the immune phenotypic characteristics of childhood acute myeloid leukemia( AML) and its clinical significance. Methods: The immune phenotype in 127 cases with childhood AML were detected by four color flow cytometry with CD45/SSC double parameters scatter plot setting as door,and then the antigentic expressions were analysed. Results: In 127 patients with childhood AML,the Myeloid antigen of CD33,CD13,CD117 showed highly expressed. The positive rates were 95. 3%,90. 6%,90. 6%. Hematopoietic stem/progenitor cell marker antigen CD34,HLA-DR and CD38 were expressed in AML with the rates of 53. 5%,71. 6% and 97. 6%. The lymphoid antigen was positive in 65. 4% of cases,with the highest frequency of CD5 6( 3 8. 6 %) followed by CD7( 21. 3%). The expression of CD34~+and HLA-DR~+patients in LymAg~+group were significantly higher than LymAg~-group( P < 0. 05). Conclusion: The immunophenotyping played an important role in diagnosis and classification of childhood AML.
引文
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[12]Sharma M,Sachdeva MU,Varma N,et al.Characterization of immunophenotypic aberrancies in adult and childhood acute lymphoblastic leukemia:A study from Northern India[J].J Cancer Res Ther,2016,12(2):620-626.
[13]Cui W,Zhang D,Cunningham MT,et al.Leukemia-associated aberrant immunophenotype in patients with acute myeloid leukemia:Changes at refractory disease or first relapse and clinic opathological findings[J].Int J Lab Hematol,2014,36(6):636-649.
[2]Bene MC,Grimwade D,Haferlach C,et al.Leukemia diagnosis:Today and tomorrow[J].Eur J Haematol,2015,95(4):36-73.
[3]Gorczyca W.Acute promyelocytic leukemia:Four distinct patterns by flow cytometry immunophenotyping[J].Pol J Pathol.2012,63(1):8-17.
[4]Ferrari A,Bussaglia E,Ubeda J,et al.Immunophenotype distinction between acute promyelocytic leukaemia and CD15-CD34-HLA-DR-acute myeloid leukaemia with nucleophosmin mutations[J].Hematol Oncol,2012,30(3):109-114.
[5]Mendoza AS,Qing X,Dungo M,et al.HLA-DR antigen-positive between acute promyelocytic leukemia[J].Exp Mol Pathol,2016,101(2):197-200.
[6]Choi Y,Lee JH,Kim SD,et al.Prognostic implications of CD14positivity in acute myeloid leukemia arising from myelodysplastic syndrome[J].Int J Hematol,2013,97(2):246-255.
[7]Bhushan B,Chauhan PS,Saluja S,et al.Aberrant phenotypes in childhood and adult acute leukemia and its association with adverse prognostic factors and clinical outcome[J].Clin Exp Med,2010,10(1):33-40.
[8]Soni S,Chopra A,Bakhshi S,et al.Prognostic impact of CD56 in pediatric AML[J].Int J Lab Hematol,2015,37(6):e157-159.
[9]Martner A,Rydstrom A,Riise RE,et al.NK cell expression of natural cytotoxicity receptors may determine relapse risk in older AML patients undergoing immunotherapy for remission maintenance[J].Oncotarget,2016,40:42569-42574.
[10]Zheng MJ,Qin YZ,Zhang AM,et al.Expression and clinical significance of CD56 antigen in acute leukemia[J].J Clin Transfusion Lab Med,2014,16(1):31-34.[郑美娟,秦义组,张爱梅,等.CD56在急性白血病细胞上的表达及其意义[J].临床输血与检验,2014,16(1):31-34.]
[11]Garcia-Dabrio MC,Hoyos M,Brunet S,et al.Complex measurements may be required to establish the prognostic impact of immunophenotypic markers in AML[J].Am J Clin Pathol,2015,144(3):484-492.
[12]Sharma M,Sachdeva MU,Varma N,et al.Characterization of immunophenotypic aberrancies in adult and childhood acute lymphoblastic leukemia:A study from Northern India[J].J Cancer Res Ther,2016,12(2):620-626.
[13]Cui W,Zhang D,Cunningham MT,et al.Leukemia-associated aberrant immunophenotype in patients with acute myeloid leukemia:Changes at refractory disease or first relapse and clinic opathological findings[J].Int J Lab Hematol,2014,36(6):636-649.