CD25在非急性早幼粒细胞白血病且非核心结合因子相关急性髓细胞白血病的急性髓细胞白血病中的表达及其临床意义

Expression of CD25 in acute myelocytic leukemia （non acute promyelocytic leukemia and non core binding factor positive acute myelocytic leukemia） and its prognosis

目的 明确CD25抗原分子表达在急性髓细胞白血病（AML）[非急性早幼粒细胞白血病（APL）且非核心结合因子相关急性髓细胞白血病（CBF-AML）]中的临床意义.方法 收集2012年1月至2017年8月郑州大学第一附属医院171例AML（非APL且非CBF-AML）患者的临床及随访资料并回顾性分析CD25在AML（非APL且非CBF-AML）中的表达情况及患者的一般临床特点.结果 在AML（非APL且非CBF-AML）中,CD25阳性组患者完全缓解比仅为8/18,而CD25阴性组患者的完全缓解率达71.24％（109/153）,差异有统计学意义（χ2=5.353,P=0.021）;复发患者在CD25阳性组占比高达6/8,在CD25阴性组中复发率为31.19％（34/109）,差异有统计学意义（χ2=6.357,P=0.012）.CD25阳性患者较CD25阴性患者有更短的无复发生存期（χ2=13.68,P〈0.001）、更短的总生存期（χ2=12.26,P〈0.001）.CD25阳性组预后与高危组预后相当,且与低危组、中危组比较差异有统计学意义（P〈0.05）.结论 在AML（非APL且非CBF-AML）中,CD25阳性表达的患者预后不良,其预后与现有预后分层中的高危组相当,可以作为现有预后分层的有机补充.

Objective To explicit the prognostic value of CD 25 antigen molecule expression in acute myelocytic leukemia （ AML） , except acute promyelocytic leukemia （ APL） and core binding factor positive acute myelocytic leukemia （ CBF-AML ） .Methods The clinical and follow-up data of 171 patients with AML （ non-APL and non-CBF-AML） in the First Affiliated Hospital of Zhengzhou University From January 2012 to August 2017 were collected , and the expression of CD 25 and the general clinical characteristics of patients were retrospectively analyzed .Results In patients with AML （ non-APL an non-CBF-AML） , the complete remission rate in CD25 positive group was only 8/18, and it was 71.24%（109/153） in CD25 negative group, the difference was statistically significant （χ2 =5.353, P=0.021） . The recurrence rate in CD25 positive goup was 6/8, and it was 31.19% （34/109） in CD25 negative group, the difference was statistically significant （χ2 =6.357, P=0.012）.CD25-positive patients had shorter relapse-free survival （RFS,χ2 =13.68, P〈0.001） and shorter overall survival （OS,χ2 =12.26, P〈0.001） than CD25-negative patients.The prognosis of CD25 positive group was similar to that of high-risk group, and it was significantly different from those of low-risk group and the middle-risk group （P〈0.05）.Conclusions InAML （non-APL and non CBF-AML）, patients with positive expression of CD25 have a poor prognosis , and their prognosis is comparable to those of high-risk group in the existing prognostic stratification , and can be used as an organic supplement to the existing prognostic stratification .