急性白血病细胞G-CSF、GM-CSF受体的检测及其临床意义

The detection of G-CSFR and GM-CSFR expression and its significance in acute leukemia

目的研究急性白血病(AL)患者骨髓单个核细胞表面粒细胞集落刺激因子受体(G-CSFR)与粒-巨噬细胞集落刺激因子受体(GM-CSFR)的表达规律,观察重组人粒细胞集落刺激因子(rhG-CSF)在AL中应用的临床疗效。方法采用流式细胞术检测15例正常对照和86例AL患者G-CSFR、GM-CSFR的表达率,观察rhG-CSF的应用对AL治疗的影响。结果急性非淋巴细胞白血病(ANLL)患者G-CSFR、GM-CSFR的表达率明显高于急性淋巴细胞白血病(ALL)(P<0.01),均低于对照组。AL患者G-CSFR与GM-CSFR表达率无相关性(rs=0.127,P>0.20);ANLL患者,G-CSFR表达率与CD13、MPO表达率呈正相关(P<0.01),与CD33表达率呈负相关(P<0.01),GM-CSFR表达率与HLA-DR表达率呈正相关(P<0.01)。ALL患者,GM-CSFR的表达率与CD19的表达率呈正相关(P<0.01)。应用rhG-CSF能减少AL患者中性粒细胞缺乏及发热的天数,但对缓解率无影响。结论G-CSFR、GM-CSFR的表达率在ANLL与ALL中有差异,两者的表达无相关性,在化疗过程中及化疗后应用rhG-CSF对AL的缓解率无显著影响。

Objective： To investigate the G-CSFR and GM-GSFR expression in bone marrow mononuclear cell and observe the clinical effect of rhG-CSF in acute leukemia.Method：We detected the level of G-CSFR and GM-CSFR by flow cytometry in fifteen normal controls and eighty-six patients with acute leukemia, and observed the clinical effect of rhG-CSF in patients with acute leukemia. Result, G-CSFR and GM-CSFR expression rates of ANLL patients group were significantly higher than that of ALL patients group （ P 〈0.01）, and all lower than nor mal control group. There was no correlation between G-CSFR and GM-CSFR in patients with acute leukemia （rs = 0. 127, P 〉0.05）. In patients with ANLL, G-CSFR expression rates had positive correlations with CD13 and MPO expression rates （ P 〈0.01） and had negative correlations with CD33 expression rates （ P 〈0.01）. GM- CSFR expression rates had positive correlations with HLA-DR expression rates （ P 〈0.01）. In patients with ALL, GM-CSFR expression rates had positive correlations with CD19 expression rates （P〈0.01）. rhG-CSF can reduced the neutropenia and febrile days in ANLL patients, but had no influences on remission rate. Conclusion： There was significant difference between G-CSFR and GM CSFR expression in patients with acute leukemia. There were no correlations between G-CSFR and GM-CSFR expression rates, rhG-CSF had not influences on remission rate of patients during or after chemotherapy with acute leukemia.