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目的:探讨黏附分子CD56、CD44、CD54、CD11a在急性髓系白血病(AML)骨髓中的表达情况及临床意义。方法:流式细胞仪检测57例AML患者和20例正常对照者骨髓单个核细胞表面CD56、CD44、CD54、CD11a的表达水平,分析其与AML患者白细胞计数、白细胞淤滞及早期病死率的关系。结果:1CD56仅在AML组表达(AML组表达率为35.1%,正常对照组0,P<0.05),其在AML高白细胞(HAML)组的表达率(53.3%)高于AML非高白细胞(NHAML)组(28.6%),白细胞淤滞组(62.5%)高于无白细胞淤滞组(28.9%)(P<0.05);2AML患者骨髓单个核细胞表面CD44的平均荧光强度在HAML组显著高于NHAML组(P<0.05),其表达与AML患者外周血白细胞计数呈正相关(r=0.446,P<0.01)。CD56、CD54、CD11a在HAML组与NHAML组、无白细胞淤滞组与白细胞淤滞组的平均荧光强度均差异无统计学意义(P>0.05)。3AML患者中HAML组、白细胞淤滞组患者的早期病死率(33.3%、25.0%)分别明显高于NHAML组、无白细胞淤滞组(0、0)。结论:CD56在HAML患者和白细胞淤滞患者有更高的表达率,有可能是AML患者预后不良的因素之一;CD44在AML患者骨髓中的表达水平与外周血白细胞计数呈正相关,可能参与HAML的发生。CD54、CD11a与HAML及白细胞淤滞的关系不十分密切。
Objective: To investigate the expression and clinical significance of adhesion molecules CD56, CD44, CD54 and CD11a in bone marrow of acute myeloid leukemia (AML). Methods: The expression of CD56, CD44, CD54 and CD11a on bone marrow mononuclear cells from 57 patients with AML and 20 normal controls were detected by flow cytometry. The relationship between leukocyte count, leukocyte stasis and early mortality was analyzed. Results: The expression of CD56 was only expressed in AML group (35.1% in AML group and 0 in normal control group, P <0.05). The expression of CD56 was higher in AML hyperplasia group (53.3% NHAML group (28.6%), leukocyte stasis group (62.5%) were higher than those without leukocyte stasis group (28.9%) (P <0.05). The mean fluorescence intensity of CD44 on bone marrow mononuclear cells in 2 AML patients was significantly higher than that in NHAML patients Group (P <0.05). There was a positive correlation between the expression of leukocyte and peripheral blood leukocyte count in patients with AML (r = 0.446, P <0.01). The mean fluorescence intensity of CD56, CD54 and CD11a in HAML group and NHAML group was no significant difference (P> 0.05). In 3AML patients, the early mortality (33.3%, 25.0%) in HAML group and leukostasis group were significantly higher than that in NHAML group and no leukocyte stasis group (0,0), respectively. Conclusion: The higher expression rate of CD56 in HAML patients and patients with leukostasis may be one of the factors of poor prognosis in AML patients. The expression of CD44 in bone marrow of AML patients is positively correlated with peripheral blood leukocyte count and may be involved in HAML occur. The relationship between CD54, CD11a and HAML and leukocyte stasis is not very close.