CD56在急性髓系白血病细胞上的表达及微小残留病分析

Expression of CD56 in the cells of acute myeloid leukemia and its clinical significance in minimal residual disease

目的探讨CD56在非M3急性髓系白血病(AML)中的表达及在微小残留病(MRD)检测的意义。方法应用流式细胞术分析145例非AML-M3 AML患者免疫表型,以CD56、CD19、CD117、CD34、CD33为标志,CD45设门MRD分析。结果 145例AML患者中CD56阳性37例,占25.52%,CD19阳性17例,占11.72%,分布在M1、M2、M4、M5。CD56或/和CD19阳性的AML患者共49例,其中CD56和CD19同时阳性5例,均为M2亚型。P170蛋白阳性36例,占24.83%,其表达率与CD56呈显著正相关(P<0.01)。48例AML患者在诱导治疗结束和维持治疗第14、32、56周作MRD检测。单纯CD56+组MRD阳性率93.55%,复发率77.41%,与单纯CD19+组(MRD阳性率25.00%,复发率0)比较,差异有统计学意义(P均<0.01)。CD56+CD19+组MRD阳性率100.00%,复发率80.00%,与单纯CD56+组比较,差异无统计学意义(P>0.05),与单纯CD19+组比较,差异有统计学意义(P<0.01)。结论 CD56、CD19在非M3 AML有较高的表达率。用CD45设门以CD56、CD19、CD34、CD117、CD33为组合的MRD方案能有效检测MRD。

Objective To investigate the expression of CD56 in non-M3 acute myeloid leukemia（AML） and its clinical significance in the determination of minimal residual disease（MRD）.Methods The immunophenotype of 145 patients with non AML-M3 AML was analyzed by flow cytometry as the markers of CD56,CD19,CD117,CD34 and CD33.MRD analysis was gated by CD45.Results CD56 and CD19 expressions were detected in 25.52%（37/145） and 11.72%（17/145） in patients with AML-M1,M2,M4 and M5,respectively.The data showed that 49 patients with AML were CD56 and /or CD19 positive,whose CD56 and CD19 both positive were all patients with AML-subtype M2（5 cases）.Meanwhile,P170 which was strongly associated with the CD56 expression was observed in 24.83%（36/145） of patients with AML（P 0.01）.MRD was determined in 48 patients with AML after induction chemotherapy or at the 14th,32th and 56th week during the consolidation chemotherapy.MRD was observed in 93.55% of CD56 positive patients with AML,and the the relapse rate was 77.41%.The positive rate of MRD in CD19＋ patients was 25.00% without relapse.There was statistical significance between the CD56＋ and CD19＋ patients with AML（P 0.01）.The data also showed that MRD existed in all CD56＋CD19＋ patients with AML which the relapse rate was 80.00%.There was no significant difference with that of CD56＋ patients with AML（P 0.05）,and there was significant difference with that of CD19＋ patients with AML（P 0.01）.Conclusions CD56,CD19 express highly in non-M3 patients with AML.CD45 gating analysis with CD56,CD19,CD34,CD117,CD33 as a combination is an effective MRD diagnostic program.