急性髓系白血病患者外周血TK1和SPF的分析

TK1 and SPF in peripheral blood of acute myeloid leukemia patients

目的探讨外周血胸腺嘧啶核苷激酶1(TK1)和S期细胞百分比(SPF)在急性髓系白血病(AML)诊断、疗效监测及预后中的意义。方法选取AML患者58例、血液系统良性增殖疾病患者(良性增殖组)6例和体检健康者(正常对照组)20名,采用印迹免疫-增强发光法检测TK1,采用流式细胞术(FCM)检测SPF。58例AML患者经1个疗程的标准诱导治疗后,比较治疗前、缓解组(39例,其中完全缓解11例、部分缓解28例)和未缓解组(19例)的TK1和SPF;同时检测58例AML患者治疗后1周和1个月的TK1和SPF。结果 AML组治疗前TK1为(2.43±1.02)pmol/L、SPF为(4.62±2.33)%,明显高于良性增殖组[TK1为(1.12±0.41)pmol/L、SPF为(2.62±1.05)%]及正常对照组[TK1为(0.39±0.15)pmol/L、SPF为(2.21±0.96)%](P<0.05)。AML完全缓解组TK1为(0.78±0.44)pmol/L、SPF为(1.89±1.23)%,明显低于治疗前和未缓解组[TK1为(4.26±0.46)pmol/L、SPF为(5.58±3.12)%](P<0.05)。AML患者治疗1个月后,TK1和SPF分别为(1.97±0.89)pmlol/L和(2.89±1.03)%,明显低于治疗前(P<0.05)。结论外周血TK1联合SPF检测能更准确地预测AML的细胞增殖情况,可很好地指示AML的治疗及提示预后。

ObjectiveTo evaluate thymidine kinase 1（TK1） and S-phase fraction（SPF） in peripheral blood for the diagnosis,treatment monitoring and prognosis of acute myeloid leukemia（AML）. MethodsA total of 58 patients with AML were enrolled,and 6 patients with benign proliferative disease in hematological system and 20 healthy subjects were enrolled as well. TK1 levels were determined by dot-blot enhanced chemiluminescence,and SPF were calculated by ？ow cytometry. After a standard inductive treatment,the levels of TK1 and SPF were compared in remission group（39 cases,including 11 cases of complete remission and 28 cases of partial remission） and non-remission group（19 cases） with those before treatment. The levels of TK1 and SPF were determined at the time points of a week and a month after treatment. ResultsThe levels of TK1 [（2.43±1.02）pmol/L] and SPF[（4.62±2.33）%] in AML group before treatment were higher than those in benign proliferative disease group [（1.12±0.41）pmol/L and（2.62±1.05）%] and healthy control group[（0.39±0.15）pmol/L and（2.21±0.96）%]（P〈0.05）. The levels of TK1 [（0.78±0.44） pmol/L] and SPF [（1.89±1.23）%] decreased in complete remission group compared with those before treatment and in non-remission group [（4.26±0.46）pmol/L and（5.58±3.12）%]（P〈0.05）. After a standard inductive treatment for a month,the levels of TK1 [（1.97±0.89）pmol/L] and SPF [（2.89±1.03）%] were lower than those before treatment（P〈0.05）. ConclusionsThe combined determination of TK1 and SPF is accurate for the proliferation status of AML and can indicate treatment and prognosis status of AML.