CD13在费城染色体阴性急性B淋巴细胞白血病中的表达及其临床意义

Expression of CD13 in Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia and its clinical significance

目的 分析成年人和儿童急性B淋巴细胞白血病（B-ALL）的免疫表型,观察髓系抗原CD13的表达与费城染色体阴性（Ph-）B-ALL患者的临床特征、血液学特点和临床预后的关系.方法 采用多参数流式细胞术检测111例成年和32例儿童B-ALL患者免疫表型.结果 儿童与成年B-ALL患者CD13、CD33阳性表达率差异均无统计学意义[31.3 ％（10/32）比19.8 ％（22/111）,18.8 ％（6/32）比29.7 ％（33/111）,均P＞ 0.05].在Ph-B-ALL患者中,儿童CD13阳性表达率高于成年人[32.3％（10/31）比9.4％（6/64）,P＜ 0.05].在儿童和成年Ph-B-ALL患者中,CD13＋和CD13-患者的诱导完全缓解率和缓解时间差异均无统计学意义（均P＞ 0.05）.在儿童Ph-B-ALL患者中,CD13＋和CD13-患者的复发时间差异有统计学意义[（111±16）d比（683±57）d,P＜0.000 1].儿童和成年CD 13＋Ph-B-ALL患者的复发时间差异亦有统计学意义[（111±16）d比（319± 16）d,P＜ 0.000 1].结论 在Ph-B-ALL患者中,儿童CD13阳性表达率明显高于成年人,CD13＋ Ph-B-ALL患者尤其是儿童CD 13＋ Ph-B-ALL患者更易复发.

Objective To analyze the immunophenotypes of B-cell acute lymphoblastic leukemia（B-ALL） and correlation between the expression of CD13 and clinical,hematologic and biological parameters in patients with Philadelphia chromosome-negative （Ph-） B-ALL.Methods Multiparameter flow cytometry was used to analyze the immunophenotypes of the bone marrow blasts in 111 cases of adult and 32 cases of childhood B-ALL.Results The positive rates of CD13 and CD33 in childhood B-ALL patients were no differences compared with those in adult patients [31.3 %（10/32） vs 19.8 %（22/111）,18.8%（6/32） vs 29.7% （33/111）,both P〉 0.05].In de novo Ph B-ALL,the frequency of CD13 in childhood patients was higher than that in adult patients [32.3 %（10/31） vs 9.4 %（6/64）,P〈 0.05].There were no statistical differences on CR after induction therapy or remission time between CD13＋ and CD13-groups in childhood or adult Ph-B-ALL patients （P〉 0.05）.Difference on time of relapse was found between CD13＋ and CD13-groups in childhood Ph-B-ALL patients[（111±16） d vs （683±57） d,P〈 0.000 1].The time of relapse between childhood and adult CD13＋ Ph B-ALL cases had statistical difference [（111±16） d vs （319±16） d,P〈 0.000 1].Conclusions The positive rate of CD13 is higher in childhood Ph-B-ALL patients than that in adult Ph-B-ALL patients.CD13＋ Ph-B-ALL patients,in particular,childhood Ph-CD13＋ patients are more likely to relapse.