急性早幼粒细胞白血病黏附分子的表达及其临床意义

Expression and Clinical Significance of Cell Adhesion Molecules in Acute Promyelocytic Leukemia

目的探讨全反式维甲酸(ATRA)及柔红霉素化疗前后急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)细胞黏附分子的表达情况,并探讨其临床意义。方法 32例APL患者分为高危组(入院时白细胞计数高于10×109/L)和低危组(入院时白细胞计数低于10×109/L),观察维甲酸及柔红霉素治疗前后APL细胞黏附分子CD49d、CD11b、CD11a、CD54、CD15及CD62L的表达水平。结果治疗前APL细胞表面均明显表达CD49d、CD11b、CD11a和CD54,而CD15、CD62L表达阴性,高危组患者APL细胞黏附分子的表达水平高于低危组(P<0.05);ATRA诱导3 d后两组APL细胞黏附分子的表达水平均高于治疗前,但高危组的表达水平高于低危组(P<0.05);ATRA诱导3 d后加用柔红霉素化疗后1周,黏附分子的表达水平较化疗前明显降低(P<0.05),但仍高于治疗前。结论初发APL细胞高表达CD49d、CD11b、CD11a和CD54,ATRA诱导治疗后APL细胞CD49d、CD54的表达水平明显升高,加用化疗药物后可降低CD49d、CD54的表达水平。

Objective To investigate the expression and clinical significance of cell adhesion molecules in acute pro- myelocytic leukemia （APL） cells before and after the treatment of alltrans retinoic acid （ATRA） and Daunorubiein. Methods Thirty - two APL patients were divided into two groups according to the levels of white blood cells （WBC） on admission ： the high risk group （ WBC 〉 10 x 109/L） and the low risk group （ WBC 〈 10 x 109/L）. Expression levels of adhesion molecules in- cluding CD49d , CDub, CDIla, CD54, CD^s, and CD62L before and after ATRA and Daunorubicin treatment were measured by flow cytometry. Results Before treatment, CD49d, CDllb, CDlla and CD~ were positively expressed, with expression levels in the high risk group higher than in the low risk group （ P 〈 0.05 ） , while CD15 and CD62L were negatively expressed in all APL cells. Three days after ATRA treatment, expression levels of adhesion molecules were increased significantly with the high risk group higher than the low risk group （ P 〈 0. 05 ）. Cells were further treated with Daunorubicin for a week after the 3 - day ATRA treatment with the same indices measured again. Expression levels of adhesion molecles were decreased （ P 〈 0. 05 ）, but still higher than before ATRA treatment. Conclusion All APL cells express the CD49d, CI）ub, CDna and CDs4 molecules. The ex- pression levels of CD49d and CD~ increased significantly after ARTA administration and an additional chemotherapy can ruduce the levels of CD~, and CD,o~ expression.