吉林大学学报(医学版) ›› 2015, Vol. 41 ›› Issue (02): 362-368.doi: 10.13481/j.1671-587x.20150231

• 临床研究 • 上一篇    下一篇

急性髓系白血病患者白血病细胞CD34和CD38抗原的表达及其临床意义

魏姗姗1,2, 周茂华3, 李劲高4, 陈景5, 陈少贤5, 李倩2, 夏平方2, 彭琪2, 佘妙容2   

  1. 1. 南方医科大学第二临床医学院内科, 广东 广州 510515;
    2. 广东省人民医院血液科 广东省医学科学院, 广东 广州 510080;
    3. 广东省人民医院检验科 广东省医学科学院, 广东 广州 510080;
    4. 中山大学孙逸仙 纪念医院肾内科, 广东 广州 510120;
    5. 广东省人民医院病理生理学研究室 广东省医学科学院, 广东 广州 510080
  • 收稿日期:2014-11-12 出版日期:2015-03-28 发布日期:2015-04-04
  • 通讯作者: 佘妙容, 主任医师, 博士研究生导师(Tel:020-83827812, E-mail:SMR807@163.com) E-mail:SMR807@163.com
  • 作者简介:魏姗姗(1988-), 女, 湖北省襄阳市人, 在读医学硕士, 主要从事白血病干细胞方面的研究。
  • 基金资助:

    国家自然科学基金资助课题(81370664);广东省科技厅科技攻关计划项目资助课题(2013B021800188);广东省中医药管理局科研项目资助课题(20131103)

Expressions of CD34 and CD38 antigens in leukemia cells of patients with acute myeloid leukemia and their clinical significances

WEI Shanshan1,2, ZHOU Maohua3, LI Jingao4, CHEN Jing5, CHEN Shaoxian5, LI Qian2, XIA Pingfang2, PENG Qi2, SHE Miaorong2   

  1. 1. Department of Internal Medicine, Second College of Clinical Medicine, Southern Medical University, Guangzhou 510515, China;
    2. Department of Hematology, Penple's Hospital of Guangdong Province, Guangdong Academy of Medical Sciences, Guangzhou 510080, China;
    3. Department of Clinical Laboratory, People's Hospital of Guangdong Province, Guangdong Academy of Medical Sciences, Guangzhou 510080, China;
    4. Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China;
    5. Department of Pathophysiology, People's Hospital of Guangdong Provice, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
  • Received:2014-11-12 Online:2015-03-28 Published:2015-04-04

摘要:

目的:探讨初诊急性髓系白血病(AML)患者白血病细胞CD34和CD38抗原表达与预后的关系,阐明CD34和CD38抗原表达在预测AML患者预后中的作用。方法:收集初诊AML患者94例,采用流式细胞术检测AML患者白血病细胞CD34和CD38抗原的表达,依据CD38抗原表达将患者分为CD34+ CD38-组(n=36)和CD34+CD38+组(n=58)。2组患者诱导方案均为IA方案。比较2组患者完全缓解率(CRR)、复发率、中位总生存时间(OS)、中位无病生存时间(DFS)和生存率。结果:CD34+ CD38-组患者CRR为77.8%,CD34+CD38+组为86.2%,2组患者诱导治疗后CRR比较差异无统计学意义(P>0.05);CD34+ CD38-组患者总复发率和1年内复发率(53.8%和36.0%)均高于CD34+CD38+组(27.9%和14.3%)(P<0.05);CD34+ CD38-组患者中位OS(13.60个月)小于CD34+CD38+组(20.33个月)(P<0.05);CD34+ CD38-组患者中位DFS(12.87个月)小于CD34+CD38+组(33.93个月)(P<0.05)。CD34+ CD38-组患者1年和2年生存率(52.8%和38.9%)低于CD34+CD38+组(75.9%和48.3%)(P<0.05)。结论:白血病细胞CD34+ CD38-抗原的表达为初诊AML患者提供一个新的预后指标,表达CD34+ CD38-抗原患者预后不良。

关键词: CD34+ CD38-, CD34+CD38+, 急性髓系白血病, 预后, 去甲氧柔红霉素

Abstract:

Objective To investigate the expressions of CD34 and CD38 antigens in the leukemia cells in the patients with firstly-diagnosed acute myeloid leukemia (AML) and their relationships with the prognosis,and to explore the role of the expressions of CD34 and CD38 antigens in predicting the prognosis of the AML patients.Methods The expressions of CD34 and CD38 antigens in the leukemia cells in 94 cases of AML patients were detected by flow cytometry. 36 patients with CD34+ CD38- antigen and 58 patients with CD34+CD38+ antigen were identified by the expressions of CD38 and treated with IA Regimen. The complete remission rate (CRR),the relapse rate,the median overall survival (OS),the median disease free survival (DFS) and the survival rate of the patients in two groups were compared.Results There was no significant difference of the CRR of the patients between CD34+ CD38- and CD34+CD38+ groups (77.8% vs 86.2%,P>0.05). However,the relapse rate and the 1-year relapse rate of the patients with CD34+ CD38- antigen (53.8% and 36.0%) were higher than those of the patients with CD34+CD38+ antigen(27.0% and 14.3%)(P<0.05).The median OS and median DFS of the patients in CD34+ CD38- group (13.60 months and 12.87 months) were shorter than those in CD34+CD38+ group (20.33 months and 33.93 months) (P<0.05).The 1-year and 2-year survival rates of the patients in CD34+ CD38- group (52.8% and 38.9%) were lower than those in CD34+CD38+ group (75.9% and 48.3%)(P<0.05).Conclusion The expression of CD34+ CD38- antigen in the leukemia cells offers a new prognostic factor for the AML patients. The expression of CD34+ CD38- antigen predicts a worse prognosis in the AML patients.

Key words: CD34+ CD38-, CD34+CD38+, acute myeloid leukemia, prognosis, idarubicin

中图分类号: 

  • R733.7