CD_(44)与nm23·H_1在急性髓系白血病中表达的临床意义

CLINICAL SIGNIFICANCE OF CD 44 AND nm23·H 1 EXPRESSIONS IN ACUTE MYELOID LEUKEMIA

目的：了解粘附分子与抑制肿瘤转移基因ｎｍ２３·Ｈ１在急性髓系白血病（ＡＭＬ）细胞上表达的临床意义。方法：用间接免疫荧光染色，流式细胞术分析６８例初治ＡＭＬ治疗前后ＣＤ４４和ｎｍ２３·Ｈ１的表达。结果：６８例中ＣＤ＋４４／ｎｍ２３·Ｈ＋１３０例中有１４例肝脾肿大，１０例脾肿大，２例淋巴结肿大，１０例中枢神经系统白血病，４例牙龈增生，６例骨痛；ＣＤ－４４／ｎｍ２３·Ｈ＋１１６例中６例肝脾肿大，２例肝、脾、淋巴结肿大；ＣＤ－４４／ｎｍ２３·Ｈ－１２２例无髓外浸润表现。ＣＤ＋４４／ｎｍ２３·Ｈ＋１者完全缓解率为８６．７％，ＣＤ－４４／ｎｍ２３·Ｈ＋１者为７５．０％，ＣＤ－４４／ｎｍ２３·Ｈ－１者则为８１．８％。６例完全缓解后ＣＤ＋４４／ｎｍ２３·Ｈ＋１者早期髓外复发。结论：ＣＤ４４和ｎｍ２３·Ｈ１表达对ＡＭＬ的治疗效果无影响，表达阳性者易有髓外浸润和早期髓外复发。

Objective:To study the expressions of adhesion molecule CD 44 and tumour metastasis inhibiting gene nm23·H 1 and their clinical significance in acute myeloid leukemia(AML).Methods:Indirect immunofluorescence staining and flow cytometry were used to study the pre and post therapeutic expressions of CD 44 and nm23·H 1 in 68 cases of AML.Results:In 30 cases with CD + 44 and nm23·H + 1,14 showed hepatosplenomegaly,10 splenomegaly,2 enlarged lymph nodes,10 central nervous system leukemia,4 hyperplastic gum,and 6 bone pain.In 16 cases of nm23·H + 1,6 revealed hepato splenomegaly,and 2 enlarged liver,spleen and lymph nodes.There was no extramedullary manifestations in 22 cases with CD - 44 and nm23·H - 1.The complete remission rate in CD + 44 /nm23·H + 1,nm23·H + 1,and CD - 44 /nm23·H - 1 cases accounted for 86.7 %, 75.0 %,and 81.8 %,respectively.Early extramedullary relapse occurred in 6 cases of complete remission with persistent CD + 44 /nm23·H + 1.Conclusion:CD 44 and nm23·H 1 expressions have no influence on therapeutic effects in AML.Positive expressions of CD 44 and nm23·H 1 are prone to extramedullary infiltrations and early extramedullary relapse.