急性B淋巴系白血病细胞CD271表达和血清神经生长因子水平的临床意义

Clinical Significance of Serum NGF Level and CD271 Expression in Patients with Acute B Lymphoid Leukemia

本研究检测急性B淋巴系白血病(B-ALL)患者血清神经生长因子(NGF)水平及骨髓白血病细胞群表面NGF低亲和性受体CD271的表达,并探讨两者的临床意义。应用酶标记免疫吸附分析法测定B-ALL患者血清NGF水平,应用流式细胞术测定患者骨髓白血病细胞群表面CD271的表达水平。结果表明,病例组患者NGF水平与对照组比较明显升高(t=4.191,p<0.05),而白血病细胞表面CD271表达与对照组比较明显降低(t=4.898,p<0.05)。25例初治B-ALL患者经CVAD方案化疗1个周期后完全缓解(CR)率为64%(16/25)。未缓解(NR)组患者化疗后NGF水平和CD271表达与对照组比较差异均有统计学意义(t=3.976,p<0.05和t=5.052,p<0.05),而CR组化疗后NGF水平和CD271表达与对照组比较差异均无统计学意义(t=1.102,p>0.05和t=1.150,p>0.05)。CR组和NR组患者化疗前CD271表达比较差异有统计学意义(t=3.889,p<0.05),但NGF水平比较差异无统计学意义(t=0.476,p>0.05)。CR组和NR组患者化疗后NGF水平及CD271表达比较差异均有统计学意义(t=3.751,p<0.05和t=4.678,p<0.05)。50%(8/16)例患者在随访过程中复发,复发患者NGF水平和CD271表达分别为(168.00±61.66)pg/ml和(52.29±13.00)%,与对照组比较差异均有统计学意义(t=5.284,p<0.05和t=6.073,p<0.05),余8例患者在缓解期NGF水平和CD271表达分别为(81.13±25.32)pg/ml和(78.45±7.12)%,与对照组比较差异无统计学意义(t=1.228,p>0.05和t=1.144,p>0.05)。B-ALL患者NGF高水平组和低水平组生存时间比较差异无统计学意义(p=0.750),同时CD271高表达组和低表达组生存时间比较差异无统计学意义(p=0.170)。结论:B-ALL患者血清NGF水平升高和骨髓白血病细胞CD271表达降低与白血病发生发展有关,这两项指标可能对疗效和预后判断具有一定的参考价值。

The aim of this study was to detect the nerve growth factor（NGF） level in serum and NGF low affinity acceptor CD271 expression on bone marrow leukemic cells in acute B lymphoid leukemia（B-ALL） patients and to analyze their clinical significance.The NGF level in serum and CD271 expression on leukemic cells in bone marrow were detected by enzyme linked immunosorbent assay and flow cytometry in B-ALL patients respectively.The results indicated that compared with control group,the NGF level in serum of patient group significantly increased（t=4.191,p0.05）,but CD271 expression on leukemic cells in bone marrow decreased significantly（t=4.898,p0.05）.The complete remission（CR） rate of 25 B-ALL patients was 64%（16/25） after one course of CVAD chemotherapy.There were statistically significant differences of NGF level and CD271 expression in non-remission（NR） group and control group（t=3.976,p0.05 vs t=5.052,p0.05）,but there were no statistically difference of NGF level and CD271 expression in CR group（t=1.102,p0.05 vs t=1.150,p0.05） as compared with control group.The CD271 expression before and after chemotherapy between CR and NR groups showed statistically significant differences（t=3.889,p0.05;t=3.751,p0.05 and t=4.678,p0.05 respectively）,but NGF level before and after chemotherapy showed no statistical difference between these 2 groups（t=0.476,p0.05）.50%（8/16） patients relapsed during following up,and of their NGF level（（168.00±61.66） pg/ml） and CD271 expression（（52.29±13.00）%） showed the significantly differences,compared with those in control group（t=5.284,p0.05 vs.t=6.073,p0.05）,but the NGF level 〔（81.13 ± 25.32） pg /ml〕and CD271 expression 〔（78.45 ± 7.12） % 〕of other 8 patients showed nostatistical difference as compared with control group（t = 1.228,p 0.05 vs t = 1.144,p 0.05）.Compared with lowNGF level and CD271 low expression groups,the survival time of B-ALL patients with high NGF level and CD271expression was not changed significantly（p = 0.750 vs p = 0.170）.It is concluded that the increased NGF level inserum and decreased CD271 expression on bone marrow leukemic cells in B-ALL patients are related with leukemiadevelopment and may be the useful indexes to evaluate curative effect and prognosis.