急性白血病患儿白血病干细胞表面CD96和CD71的表达对其疗效和预后的影响

doi:10.13481/j.1671-587x.20170422

摘要/Abstract

摘要： 目的：观察白血病干细胞（LSC）表面CD96和CD71表达对急性白血病患儿疗效及预后的影响，阐明白血病患儿LSC的分子生物学特征与其疗效和预后的关联性。方法：选择80例急性白血病患儿作为研究对象，其中急性淋巴细胞白血病（ALL）39例，急性髓系白血病（AML）41例。应用流式细胞术对其LSC表面CD96和CD71表达情况进行检测，对患者的首次化疗疗效、5年生存率、化疗后感染、化疗后复发和髓外浸润发生率进行观察和比较。结果：38例（47.5%）患儿LSC表面CD96阳性表达，45例（56.3%）患儿LSC表面CD71阳性表达，2种抗原阳性表达率比较差异无统计学意义（χ²=1.227，P=0.268）；AML患儿LSC表面CD96和CD71阳性表达率均明显高于ALL患儿（χ²=22.225，χ²=34.028，均P<0.01）。LSC表面CD96阴性表达患儿首次化疗后的临床有效率和疗效分布均优于LSC表面CD96阳性表达患儿，LSC表面CD71阴性表达的患儿首次化疗后的临床有效率和疗效分布优于LSC表面CD71阳性表达患儿（χ²=11.323，χ²=16.589，P<0.05；U=2.939，U=2.291，P<0.05）。LSC表面CD96阴性表达患儿的5年生存率明显高于LSC表面CD96阳性表达患儿（χ²=5.051，P<0.05），化疗后感染、化疗后复发和髓外浸润发生率明显低于LSC表面CD96阳性表达患儿（χ²=8.316，χ²=13.288，χ²=5.389，均P<0.05）；LSC表面CD71阴性表达患儿化疗后感染发生率和化疗后复发率明显低于LSC表面CD71阳性表达的患儿（χ²=6.622，χ²=10.787，均P<0.05）。结论：急性白血病患儿LSC表面的CD96和CD71表达水平与疾病亚型、首次化疗疗效具有一定的关联性，可作为辅助诊断和评价疗效的标志物；CD96的表达水平与患者的预后具有关联性，可作为预测患儿预后的指标。

关键词: CD96, CD71, 疗效, 白血病干细胞, 急性白血病, 预后

Abstract: Objective: To observe the influence of the CD96 and CD71 expressions in the surface of leukemia stem cells (LSC) in the therapeutic effects and prognosis of the children with acute leukemia,and to clarify the relationships between the molecular biological characteristics of LSC in the children with leukemia and their therapeutic effects and prognosis.Methods: Eighty children with acute leukemia were selected as the subjects. Among them, 39 cases were acute lymphoblastic leukemia (ALL) and 41 cases were acute myeloid leukemia (AML). The CD96 and CD71 expressions on the surface of LSC were detected with flow cytometry; the therapeutic effects of the first cycle chemotherapy, the survival rate of 5-year, the incidence of infection after chemotherapy, the recurrence rate after chemotherapy, and the incidence of extramedullary infiltration of the children were observed and compared.Results: The CD96 expression on the surface of LSC was positive in 38 cases (47.5%) and the CD71 expression on the surface of LSC was positive in 45 cases (56.3%);the difference of positive expression rates of CD96 and CD71 was not significant (χ²=1.227, P=0.268). The positive expression rates of CD96 and CD71 on the surface of LSC of the children with AML were significantly higher than those in the children with ALL, and the differences were statistically significant (χ²=22.225, χ²=34.028, P<0.01). The distribution of therapeutic effects and the clinical efficiency of the first cycle chemotherap, in the children with negative CD96 expression on the surface of LSC were superior to those with positive CD96 expression on the surface of LSC; the distribution of therapeutic effects and the clinical efficiency of the first cycle chemotherapy in the children with negative CD71 expression on the surface of LSC were superior than those with positive CD71 expression on the surface of LSC; the differences between two groups were statistically significant (χ²=11.323, χ²=16.589, P<0.05; U=2.939, U=2.291, P<0.05). The survival rate of 5-year in the children with negative CD96 expression on the surface of LSC was higher than those with positive CD96 expression; the incidence of infection after chemotherapy,the recurrence rate after chemotherapy and the incidence of extramedullary infiltration were lower than those with positive CD96 expression. The incidence of infection after chemotherapy and the recurrence rate after chemotherapy in the children with negative CD71 expression on the surface of LSC were lower than those with positive CD71 expression,and the differences between two groups were statistically significant (χ²=5.051,χ²=13.288, P<0.05).Conclusion: The expressions of CD96 and CD71 on the surface of LSC in the children with acute leukemia has relationship with the subtypes of the disease and the therapeutic effects of the first cycle chemotherapy, which can be used as markers for the diagnosis and evaluation of therapeutic effects. The expression level of CD96 is related to the prognosis of the patients, which can be used as an indicator for predicting the prognosis of patients.

Key words: CD71, acute leukemia, prognosis, leukemia stem cells, CD96, therapeutic effects

中图分类号:

R733.71

苏军燕, 李迎今, 徐长妍. 急性白血病患儿白血病干细胞表面CD96和CD71的表达对其疗效和预后的影响[J]. 吉林大学学报(医学版), 2017, 43(04): 776-781.

SU Junyan, LI Yingjin, XU Changyan. Influence of CD96 and CD71 expressions in surface of leukemia stem cells in therapeutic effects and prognosis of children with acute leukemia[J]. Journal of Jilin University Medicine Edition, 2017, 43(04): 776-781.

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