CD56阳性对急性早幼粒细胞白血病患者预后的影响

The effect of CD56 positive on prognosis of patients with acute promyelocytic leukemia

目的:观察CD56抗原在新发成人急性早幼粒细胞白血病(APL)患者中的表达情况,分析其免疫特点及对预后的影响。方法:分析2007年5月至2012年10月在温州市中心医院就诊的新发成人APL病例的临床资料并进行随访,根据流式细胞术测定的患者骨髓CD56抗原的表达情况,将患者分成CD56阳性组与CD56阴性组,比较2组患者的免疫特点及预后差别。结果:64例患者中CD56阳性者12例,阴性者52例,阳性率为18.75%。2组患者的CD9、CD11b、CD15、CD19、CD117、HLA-DR抗原表达差异均无统计学意义(P>0.05);CD56阳性组CD2及CD34表达率较阴性组高(分别25.00% vs. 3.85%,P=0.042;41.67% vs. 3.85%,P=0.001)。预后方面,2组患者的完全缓解率、复发率、中位总生存期及3年总生存率的差异无统计学意义(P>0.05),但 CD56阳性组髓外复发率较阴性组高(27.27% vs. 4.55%, P<0.05),3年无病生存率也低于阴性组(54.55% vs. 86.36%,P<0.05)。结论:CD56抗原阳性是新发成人APL患者预后不良的影响因素之一。

Objective: To investigate the expression of CD56 antigen in de-novo acute promyelocytic leukemia (APL) and to analyze the immuno-features and surviva1 of patients with positive CD56 expression. Methods: The expression of CD56 in bone marrow was detected by flow cytometry. Patients of de-novo acute promyelocytic leukemia who visited Wenzhou Central Hospital from May 2007 to October 2012 were followed up and their clinical data were analyzed. Immuno-features and prognosis were compared between patients expressing and nonexpressing CD56. Results: Of 64 patients,12 (18.75%) were positive for CD56. There were no statistical differences in terms of CD9,CD11b,CD15,CD19,CD117,HLA-DR surface antigen markers between CD56+ and CD56- groups (P>0.05). Expressions of CD56 were significantly associated with coexpression of CD2 and CD34 (25.00% vs. 3.85%,P=0.042; 41.67% vs. 3.85%,P=0.001). The complete remission,relapse rate,3-year median overall survival (OS) period and 3-year overall survival rate showed no significant differences between CD56+ and CD56- groups (P>0.05),while extramedullary relapse rate (27.27% vs. 4.55%,P<0.05),3-year disease free-survival (DFS) rate (54.55% vs. 86.36%,P<0.05) indicated significant differences. Conclusion: The expression of CD56 appeared to be one of adverse prognostic factors in de-novo APL.