CD34、CD38抗原在儿童急性白血病中的表达意义

The clinical significance of CD34、CD38 antigen expression in pediatric acute leukemia

目的 :探讨儿童急性白血病(acute leukemia,AL)CD34、CD38及CD34/CD38抗原表达的临床意义。方法 :采用流式细胞术对2006年1月—2015年3月住院的急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)74例及急性髓系白血病(acute myeloid leukemia,AML)27例患儿的骨髓标本进行CD34和CD38抗原检测,并比较CD34、CD38和CD34/CD38在AL患儿表达的差异及与诱导化疗的关系。结果:CD34、CD38、CD34/CD38在ALL和AML患儿中均有表达(P>0.05),提示其为AL细胞表面非特异性抗原。但CD34+、CD38+、CD34+/CD38+组完全缓解(complete remission,CR)率在AL均低于其阴性组(P<0.05),提示其表达为预后不良的因素。在ALL患儿中除CD38+组年龄较CD38-组小(U=492.0,P=0.041)、CD34+/CD38+组在白细胞(white blood cell,WBC)计数较CD34-/CD38-组低(U=90.0,P=0.027)外,余相关指标组间比较差异均无统计学意义。同时,AML患儿中CD38及CD34/CD38阳性组出血发生率均低于阴性组(P<0.05),余相关指标阳性组与阴性组比较差异均无统计学意义(P>0.05)。结论:CD34、CD38、CD34/CD38抗原在AL中非特异性表达。检测AL患者骨髓中CD34、CD38、CD34/CD38抗原的表达均可以作为预测诱导化疗疗效的指标,其高表达预示化疗效果差。

Objective： To analyze the clinical significance of CD34,CD38 and CD34/CD38 antigen expression in acute leukemia（AL） patients. Methods： CD34 and CD38 antigen were analysed in 74 cases of acute lymphoblastie leukemia（ALL） and 27 cases of acute myeloid leukemia（AML） patients with the method of flow cytometry from January 2006 through March 2015. To compare the differences expression and chemotherapy response Of CD34, CD38, CD34/CD38 in AL. Results： Suggesting nonspeeific cell antigen, CD34, CD38, CD34/CD38 antigen were expressed in both ALL and AML patients（P〉0.05）. Among AL patients, the complete remission（CR） rate of CD34^＋, CD38^＋and CD34^＋/CD38^＋ patients were significantly lower than that of CD34^-, CD38^- and CD34^-/CD38^-（P〈0.05）. The expression of CD34, CD38, CD34/CD38 were indicators of poor prognosis. The age was significantly lower in CD38^- group than that in CD38^- group in ALL（U=492.0, P=0.041）. There was significant difference in the WBC between CD34^＋/CD38^＋ and CD34^-/CD38^- group in ALL（U=90.0, P=0.027）. There was no statistically significant difference between CD34, CD38, CD34/CD38 expression and other indicators of ALL. The incidence of hemorrhage was significantly lower in CD38^＋ group than that in CD38^- group in AML（χ^2=5.073, P=0.047）. The incidence of hemorrhage was significantly lower in CD34^＋/CD38^＋ group than that in CD34^-/CD38^- group in AML（χ^2=5.178, P=0.023）. There was no statistically significant difference between CD34, CD38 and CD34/CD38 expression and other indicators of AL（P〉0.05）.Conclusion： The expression of CD34, CD38 and CD34/CD38 were nonspecific in AL patients. The expression of CD34, CD38 and CD34/CD38 can be used as the index to predict chemotherapy response in the bone marrow and its high expression indicates poor effect of chemotherapy in AL.