骨髓增生异常综合征和急性髓系白血病患者血清可溶性CD44水平检测意义

Clinical significance of serum soluble CD44s of patients with myelodysplastic syndrome and acute myeloid leukemia

目的探讨骨髓增生异常综合征(MDS)以及急性髓系白血病(AML)患者血清可溶性CD44(sol CD44)表达水平检测的临床意义。方法选择初诊的MDS患者63例作为MDS组,AML患者75例作为AML组,同时选取15例健康成年人作为对照组。采用ELISA法检测各组血清sol CD44s及sol CD44v6水平,分析比较不同亚型(RCUD、RARS、RCMD、RAEB-1和RAEB-2型)、不同危险度(低危组、中危-1组、中危-2组、高危组)MDS患者血清solCD44s水平的差异和不同分型(M3组和非M3组)AML患者血清sol CD44s及sol CD44v6水平的差异。结果 MDS组和AML组血清sol CD44s水平均明显高于对照组(P均<0.05),MDS组和AML组比较差异无统计学意义(P>0.05);AML组血清sol CD44v6水平明显高于对照组和MDS组(P均<0.05),MDS组与对照组相比差异无统计学意义(P>0.05)。RCUD、RARS、RCMD、RAEB-1和RAEB-2型MDS患者血清sol CD44s水平依次增加(P均<0.05),且随着危险度增高,血清sol CD44s水平逐渐升高(P均<0.05)。M3组血清sol CD44s和sol CD44v6水平均明显高于非M3组(P均<0.05)。结论 MDS患者血清solCD44s水平明显升高,与WHO分型、IPSS危险度分层水平相关,提示sol CD44s水平升高与MDS患者的肿瘤负荷相关,可以作为MDS诊断分型、判断预后的血清学参考指标;AML患者血清sol CD44s及sol CD44v6水平均明显升高,且水平越高提示病情越重,预后较差,sol CD44s及sol CD44v6均可以作为AML诊断分型、判断预后的血清学参考指标。

Objective It is to explore the significance of serum soluble CD44s（sol CD44s） levels determing in patients with myelodysplastic syndrome（MDS） and acute myeloid leukemia（AML）.Methods 63 cases of newly diagnosed MDS were selected as MDS group,75 cases of AML as AML group,while 15 cases of healthy adults were selected as control group.The serum sol CD44 s and sol CD44v6 levels was measured by enzyme-linked immunosorbent assay（ELISA）.The differences of the serum sol CD44 s levels with different subtypes（RCUD,RARS,RCMD,RAEB-1 and RAEB-2） and different levels of risk（Low risk,medium risk 1,medium risk 2,high risk） of MDS,and the serum sol CD44 s and sol CD44v6 levels in patients with different types（M3 and no-M3） of AML were analyzed and compared.Results The serum sol CD44 s levels of the MDS group and the AML group were both significantly higher than those of the control group（all P 〈 0.05）,but there was no significant difference between the MDS group and the AML group（P 〉 0.05）.The serum sol CD44v6 level of the AML group were significantly higher than those of the MDS group and the control group（all P 〈 0.05）,but there was no significant difference between the MDS group and the control group（P 〉 0.05）.The serum sol CD44 s levels were gradually increased according to the order of RCUD,RARS,RCMD,RAEB-1 and RAEB-2 in the MDS group（all P 〈 0.05）,and with the increase in the degree of risk（all P 〈 0.05）.Conclusion The serum sol CD44 s level of patients with MDS is significantly increased and has relationships with the WHO classification,IPSS risk stratification,suggesting that in patients with MDS,the sol CD44 s level is associated with tumor burden and can be used as a serological reference indicator on diagnosis and prognosis of MDS.The serum sol CD44 s level of the AML patients is significantly raised.Simultaneously significantly high levels of sol CD44 s and solCD44v6 in the serum of patients prompt a severe illness,and a poor prognosis.Sol CD44 s and sol CD44v6 can be used as serological reference indicators of diagnostic classification and prognosis of AML.