急性髓系白血病CD44v6的表达和ERK磷酸化水平的关系

Relationship between the CD44v6 expression and ERK phosphorlation in acute myeloid leukemia patients

目的探讨CD44V6和p-ERK1／2在AML中的表达及临床意义。方法应用流式细胞仪检测22名健康对照者及152例AML患者骨髓原始细胞上CD44V6及P—ERK1／2的表达。对其中129例AML患者进行了跟踪随访，分析CD44V6＋和CD44V6-对AML患者的复发率以及生存时间是否存在影响。结果22名健康对照者中，各有1例（4．5％）CD44V6和p-ERK1／2阳性。152例AML患者中，55例（36．2％）CD44V6阳性，97例（64．5％）p-ERKl／2阳性。AML患者组骨髓原始细胞p-ERK1／2的MFI为14（758），高于健康对照组的8（6—10），差异有统计学意义（U=4．2，P〈0．01）。CD44V6＋AML患者p-ERK1／2的MFI为28（15—61），高于CD44V6-AML患者的18（6—37），差异有统计学意义（U=6．7，P〈0．01）。CD44V6的MFI与p-ERK1／2的MFI呈显著性正相关（rs=0．7，P〈0．01）。对129例AML患者进行了4—65个月的随访，其中CD44V6患者的复发率为32．1％（26／81），低于CD44V6＋患者的复发率81．3％（39／48），差异有统计学意义（χ2=29．1，P〈0．01）。生存分析表明，CDL。6AML患者平均生存时间为（28．5±1．8）个月，CD44V6-AML患者平均生存时间为（51．2±2．0）个月，差异有统计学意义（χ2=48．2，P〈0．01）。结论CD44V6阳性的AML患者生存时间明显缩短、预后差。CD44V6可能通过上调p-ERK1／2水平促进白血病细胞增殖。

Objective To investigate expressions of CD^v6 and p-ERK1/2 in AML patients and its clinical significance. Methods Expressions of CD44v6 and p-ERK1/2 on bone marrow blasts in 152 AML patients and 22 normal controls were determined by flow cytometry. Meanwhile, the effects of CD44v6 expression （ CD44v6＋ and CDAv6- ） on relapse rate and survival time were analyzed by following up of 129 AML patients. Results Double positive expressions of CD44v6 and p-ERK1/2 were observed in 4. 5% （1/22） of the normal bone marrow blasts while single positive expression of CD44v6 and p-ERK1/2 was observed in 36. 2% （55/162） and 64. 5% （97/162） of AML patients, respectively. The MFI of p-ERK1/2 expression on blast cells in AML patients was [ 14 （7 -58 ） ], which was higher than that in normal controls [ 8 （6 - 10）, U =4. 2, P 〈0. 011. Furthermore, MFI of p-ERK1/2 expression on blast cells in CD44v6＋ AML patients was [ 28 （ 15 - 61 ） ] , which was significantly higher than that in CDAv6 AML patients [ 18 （ 6 - 37 ）, U = 6. 7, P 〈 0. 01 ]. A strong correlation was obtained between CD44v6 and p-ERK1/2 expression （ rs = 0. 7, P 〈0. 01 ）. Among 129 patients followed up for 4 to 65 months, the data also revealed that the relapse rate of CD44v6＋ AML patients was 32. 1% （26/81）, which was much lower than that in CD44v6＋ AML patients [ 81.3 % （39/48） ,χ2 = 29. 13, P 〈 0. 01 ）. And the overall survival in CD44v6＋ AML patients was （28.5 ± 1.8） months, which was significantly worse than that of CD44v6- AML patients [ （51.2±2. 0） months, χ2 =48.2, P 〈 0. 01 ）. Coneluslon CD44v6 expression was associated with a poor survival in AML patients, and CD44v6 might promote the expansion of leukemic blast cells by up-regulating p-ERK1/2.