急性单核细胞白血病CD56、CD11b表达及临床意义
급성단핵세포백혈병CD56、CD11b표체급림상의의
CD56 and CD11b antigen expressions in patients with acute monocytic leukemia and the clinical implications
  • 万方数据
    南方医科大学学报 남방의과대학학보
    JOURNAL OF SOUTHERN MEDICAL UNIVERSITY
    2009年 8期 1605-1608 ,共4页

    许娜%刘晓力%杜庆锋%刘志%钟敏%林榕%宋兰林%易正山%孟凡义%周淑芸

    허나%류효력%두경봉%류지%종민%림용%송란림%역정산%맹범의%주숙예

    CD56%CD11b%白血病%单核细胞性%核型%11q23%MLL%预后 CD56%CD11b%白血病%單覈細胞性%覈型%11q23%MLL%預後
    CD56%CD11b%백혈병%단핵세포성%핵형%11q23%MLL%예후
    CD56%CD1 lb%acute monocytic leukemia%karyotype%11q23,MLL%prognosis
    目的 探讨细胞表面分化抗原CD56、CD11b在急性单核细胞白血病(AML-M_5)的表达及临床意义.方法 采用流式细胞术,G 显带技术进行核型分析,双色混合谱系白血病(MLL)基因探针和间期荧光原位杂交(I-FISH)技术,对113例初治成人AML-M_5患者进行免疫学和细胞遗传学检测,并回顾分析其临床资料.结果 113例患者中CD56表达率28.32%(32例),CD11b表达率73.45%(83例),CD56~+患者高表达CD11b(P<0.01),且CD11b的表达水平与CD56呈正相关(P<0.05);113例患者中异常核型患者占48.67%(55例),其中伴11q23异常者占22.12%(25例):I-FISH检测MLL阳性25例;CD56、CD11b共表达的患者比CD56、CD11b双阴性患者外周血白细胞计数、骨髓原始加幼稚细胞数高(P<0.01);前者多合并异常核型,以累及11q23异常常见(P<0.05);较后者容易出现浸润表现、多为难治性白血病患者(P<0.01);且前者完全缓解率及中位生存期均较后者低(P<0.01);CD56~+患者与CD11b~+患者相比,前者合并异常核型及难治性白血病较后者多(P<0.05),而在外周血白细胞计数、骨髓原始加幼稚细胞数、髓外浸润、完全缓解率及中位生存期均无差别(P＞0.05).结论 CD56~+、高表达CD11b的AML-M_5患者易出现异常核型,以累及11q23/MLL基因异常多见,易合并髓外浸润,且多为难治性患者,预后较差.
    목적 탐토세포표면분화항원CD56、CD11b재급성단핵세포백혈병(AML-M_5)적표체급림상의의.방법 채용류식세포술,G 현대기술진행핵형분석,쌍색혼합보계백혈병(MLL)기인탐침화간기형광원위잡교(I-FISH)기술,대113례초치성인AML-M_5환자진행면역학화세포유전학검측,병회고분석기림상자료.결과 113례환자중CD56표체솔28.32%(32례),CD11b표체솔73.45%(83례),CD56~+환자고표체CD11b(P<0.01),차CD11b적표체수평여CD56정정상관(P<0.05);113례환자중이상핵형환자점48.67%(55례),기중반11q23이상자점22.12%(25례):I-FISH검측MLL양성25례;CD56、CD11b공표체적환자비CD56、CD11b쌍음성환자외주혈백세포계수、골수원시가유치세포수고(P<0.01);전자다합병이상핵형,이루급11q23이상상견(P<0.05);교후자용역출현침윤표현、다위난치성백혈병환자(P<0.01);차전자완전완해솔급중위생존기균교후자저(P<0.01);CD56~+환자여CD11b~+환자상비,전자합병이상핵형급난치성백혈병교후자다(P<0.05),이재외주혈백세포계수、골수원시가유치세포수、수외침윤、완전완해솔급중위생존기균무차별(P＞0.05).결론 CD56~+、고표체CD11b적AML-M_5환자역출현이상핵형,이루급11q23/MLL기인이상다견,역합병수외침윤,차다위난치성환자,예후교차.
    Objective To investigate the expressions of cell surface differentiation antigen CD56 and CD11b antigen in acute monocytic leukemic (AML-M_5) cells and their clinical significance. Methods A total of 113 cases of de nove adult AML-M_5 were examined genetically and immunologically using G-banding technique, interphase fluorescence in situ hybridization (I-FISH) and flow cytometry immunophenotyping, and the results were analyzed in relation to their clinical data. Results Of the 113 cases, the expression rates of CD56 and CD11b was 28.32% and 73.45%, respectively. The CD56+ patients had high CD11b expression, and the expression levels of CD11b and CD56 were positively correlated (P<0.05). The incidence of karyotypic abnormalities was 48.57% (55 cases) in these patients, including 25 (22.12%) with 11q23 aberrations. Twenty-five cases were positive for MLL gene abnormalities as found by I-FISH analysis. Compared with the patients positive for both CD56 and CD11b, those negative for both CD56 and CD11b showed increased peripheral blood white blood cell (WBC)count and also increased blast and progenitor cells in the bone marrow (P<0.05); the former patients often had karyotypic abnormalities, commonly involving 11q23 aberrations (P<0.05), whereas the latter patients presented more likely with extramedullary infiltration and refractory leukemia (P<0.01) with lowered complete remission rate and shortened median survival time (P<0.01). CD56-positive patients were more likely to have karyotypic abnormalities and refractory leukemia than CD11b-postive patients (P<0.05), but the peripheral blood WBC counts, bone marrow blast and progenitor cells,extramedullary infiltration, complete remission rate or median survival time showed no significant differences between them (P>0.05). Conclusion AML-M_5 patients with CD56 positivity and high expression of CD11b often have aberrant karyotypes,commonly involving 11q23/MLL gene abnormality. These patients frequently develop extramedullary infiltration and refractory leukemia often with poor prognosis.
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