CAJ | 학술논문

目的了解CD34在急性早幼粒细胞白血病(APL)中的表达情况,探讨CD34+APL的临床与实验窜特征.方法收集262例APL患者的临床和实验室检测资料,按照CD34的表达情况,将其分为CD34+APL组和CD34-APL组,比较两组患者的性别、发病年龄、治疗前血象、弥漫性血管内凝血(DIC)发生率、缓解率等临床特征及形态学分型、免疫学分型、染色体检查及分子生物学检查等实验窒特征.结果 262例患者中,CD34+38例,CD34-224例.CD34的表达与CD2、CD7及CD117的表达有关,CD34+APL组的CD2、CD7及CD117的阳性表达率均高于CD34-APL组(均P<0.01).CD34+APL组与CD34-APL组的发病年龄、性别构成比、外周血血红蛋白浓度及血小板计数、DIC发生率及缓解率差异均无统计学意义(均P>0.05),而外周血白细胞计数差异有统计学意义(分别为25.9×109/L和5.3×109/L,P<0.05).CD34+APL患者中,M3a型13例,M3b型21例,M3m型4例;CD34-APL患者中,M3a型133例,M3b型87例,M3m型4例,两组形态学亚型分布比较,差异有统计学意义(P<0.01).CD34+APL组中,37例(97.4%)具有特异性的t(15;17)染色体异常,CD34-API.组有199例(88.8%),两组差异无统计学意义(P>0.05).CD34+APL患者中,PML/RARa融合基因S型有22例,占57.9%,高于CD34-APL组(P<0.05).结论 CD34+APL是一种具有特殊生物学特征的APL亚型.
목적 료해CD34재급성조유립세포백혈병(APL)중적표체정황,탐토CD34+APL적림상여실험찬특정.방법 수집262례APL환자적림상화실험실검측자료,안조CD34적표체정황,장기분위CD34+APL조화CD34-APL조,비교량조환자적성별、발병년령、치료전혈상、미만성혈관내응혈(DIC)발생솔、완해솔등림상특정급형태학분형、면역학분형、염색체검사급분자생물학검사등실험질특정.결과 262례환자중,CD34+38례,CD34-224례.CD34적표체여CD2、CD7급CD117적표체유관,CD34+APL조적CD2、CD7급CD117적양성표체솔균고우CD34-APL조(균P<0.01).CD34+APL조여CD34-APL조적발병년령、성별구성비、외주혈혈홍단백농도급혈소판계수、DIC발생솔급완해솔차이균무통계학의의(균P>0.05),이외주혈백세포계수차이유통계학의의(분별위25.9×109/L화5.3×109/L,P<0.05).CD34+APL환자중,M3a형13례,M3b형21례,M3m형4례;CD34-APL환자중,M3a형133례,M3b형87례,M3m형4례,량조형태학아형분포비교,차이유통계학의의(P<0.01).CD34+APL조중,37례(97.4%)구유특이성적t(15;17)염색체이상,CD34-API.조유199례(88.8%),량조차이무통계학의의(P>0.05).CD34+APL환자중,PML/RARa융합기인S형유22례,점57.9%,고우CD34-APL조(P<0.05).결론 CD34+APL시일충구유특수생물학특정적APL아형.
Objective To explore the expression of CD34 in patients with acute promyelocytic leukemia (APL) and investigate the clinical and laboratory features of CD34+ APL patients. Methods 262 APL patients diagnosed by chromosome analysis and/or fusion gene examination in the last five years were retrospectively analyzed in this study. To survey the expression of CD34 in those patients, all the cases were divided into two groups (CD34+ APL vs. CD34+ APL). The clinical features including age, gender, abnormal values of the peripheral hemogram before treatment, the complete remission (CR) rate and the incidence of DIC and laboratory data such as the results of morphology, immunology, cytogenetics and molecular biology (MICM) between those two groups were compared. Results Of the 262 APL patients, 38 (14.5%) cases were positive for CD34 expression. There were no statistically significant differences between CD34+ APL and CD34- APL groups in gender and age (P>0.05). Before treatment, the median level of WBC in CD34+ APL was 25.92×109/L, which was significantly higher than that of CD34- APL (5.3×109/L, P<0.05). CD34+ APL by morphology classification were mostly of the subtypes M3b and M3v (65.8 %), while these subtypes in CD34- A PL (40.3 %) were significantly less (P<0.01). There were no statistically significnat differences between the two groups compared in respect of complete remission (CR) rate and the incidence of DIC (P>0.05). The expression level of CD34 in APL had correlation to the expression level of CD2, CD7 and CD117; the latter three phenotypes in CD34+ APL were significantly higher than those in CD34- APL (P<0.01). No significant difference was found between those two groups by chromosome analysis, but there was more PML-RAR-alpha transcript short form in CD34+ APL than that in CD34- APL (P<0.05). Conclusion CD34+ acute promyelocytic leukemia is a unique subtype of APL with different biological characteristics.