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目的探讨成人急性髓细胞白血病(AML)免疫表型的特点及其与疗效、复发的关系。方法选择2013年2月至2014年2月期间在我院血液科进行治疗的176例成年AML患者进行免疫表型检测,随访观察24个月,记录复发的数据。结果 176例AML患者中髓系特异性抗原主要阳性表达依次为CD13(165例、93.75%)、CD117(115例、65.34%)、CD33(109例、61.93%)、MPO(81例、46.02%)、CD64(51例、28.98%);造血干/祖细胞标记抗原主要阳性表达依次为CD38(122例、69.32%)、HLA-DR(94例、53.41%)、CD34(85例、48.30%),在176例AML患者中伴有淋系抗原阳性表达的有79例,主要为CD56(58例、32.95%)、CD7(31例、17.61%)。在176例患者中,123位患者化疗1至2个疗程后达到完全缓解,其中:HLA-DR、CD34、CD7、CD19等4个抗原表达阳性的患者的缓解率低于表达为阴性的患者(P<0.05);在24个月的随访观察中,123例得到缓解的患者当中25例出现复发,其中患者HLA-DR、CD34、CD7阳性表达的患者复发比例高(P<0.05)。结论 CD13、CD33、CD38等抗原在AML患者中表达较高,其中44.88%的患者伴有淋系抗原的表达;而患者具有CD7、CD34、CD56、HLA-DR表达阳性后出现缓解的预期值相对较低,当患者出现CD34、CD56、HLA-DR表达阳性后增加其复发的概率。
Objective To investigate the characteristics of immunophenotype in adult acute myeloid leukemia (AML) and its relationship with the curative effect and recurrence. Methods One hundred and seventy-six adult AML patients who underwent hematology in our hospital from February 2013 to February 2014 were enrolled in this study. Immunohistochemical detection was performed. The patients were followed up for 24 months and the recurrence data were recorded. Results The main positive expression of myeloid specific antigen in 176 AML patients was CD13 (93.75%), CD117 (65.34%), CD33 (109 cases, 61.93%) and MPO ), And CD64 (51 cases, 28.98%). The main positive expression of CD83 (122 cases, 69.32% ). Of the 176 AML patients, 79 cases were positive for lymphoid antigen expression, mainly CD56 (32.95%) and CD7 (31 cases, 17.61%). Among 176 patients, 123 patients achieved complete remission after one to two cycles of chemotherapy. Among them, the remission rate of patients with positive expression of HLA-DR, CD34, CD7 and CD19 was lower than those with negative expression P <0.05). In the 24-month follow-up observation, 25 of 123 patients with remission had recurrence. The patients with HLA-DR, CD34 and CD7 positive expression had a higher recurrence rate (P <0.05). Conclusion The antigens of CD13, CD33 and CD38 are highly expressed in AML patients, of which 44.88% are associated with lymphoid antigen expression. However, the expected value of remission in patients with CD7, CD34, CD56 and HLA-DR expression is positive Lower, when patients appear positive expression of CD34, CD56, HLA-DR increased the probability of its recurrence.