儿童B系急性淋巴细胞白血病CD133两种亚型分子表达的临床意义

Clinical Significance of Expression of Two Subtypes of CD133 in Children with Acute Lymphoblastic Leukemia

目的探讨儿童B系急性淋巴细胞白血病(B-ALL)CD133两种亚型分子(CD133-1、CD133-2)在初次诊断和治疗1个月后的表达与临床预后相关指标之间的关系。方法采取流式细胞术对2017年1月—2018年9月该院收治的50例B系急性淋巴细胞白血病患儿在初诊时、治疗1个月时的CD133-1、CD133-2两个单个核细胞的表达进行检测,同时也检测治疗1个月后患儿的微量残留病(MRD)相关变化情况。结果在初诊时,B系急性淋巴细胞白血病患儿50例中,CD133-1表达为阳性的有19例(38.00%),CD133-2表达为阳性的的有31例(62.00%),P<0.05);治疗1个月后,25例患儿中,CD133-1表达为阳性有3例(12.00%),CD133-2表达为阳性有22例(88.00%),P<0.05)。经化疗治疗后,B-ALL患儿的CD133-1表达的例数明显减少,但比正常的常规组高;而CD133-2表达的例数有降低,但降低速度较为缓慢。结论初诊时,B系急性淋巴细胞白血病患儿的CD133的表达同患儿的年龄、性别、异常的细胞遗传学、FAB亚型、骨髓幼稚细胞比例、基因融合表达、完全缓解率、白血病危险等级等因素无显著的相关性;B系急性淋巴细胞白血病患儿的CD133-2阳性表达比CD133-1表达高,CD133表达同CD34的表达没有相关性,CD133-2表达同与微量残留病具有显著相关性。

Objective To investigate the expression and clinical prognosis of CD133-1 and CD133-2 in children with B-lineage acute lymphoblastic leukemia (B-ALL) after primary diagnosis and treatment for 1 month. Methods Flow cytometry was performed on 50 children with B -lineage acute lymphoblastic leukemia admitted to our hospital from January 2017 to September 2018 at the time of initial diagnosis and CD133-1 and CD133-2 at the first month of treatment. The expression of nuclear cells was detected, and the changes of minimal residual disease (MRD) in children after 1 month of treatment were also examined. Results At the time of initial diagnosis, among the 50 children with Bline acute lymphoblastic leukemia, 19 cases (38.00%) were positive for CD133-1, and 31 were positive for CD133-2 (62.00%)(P<0.05). After 1 month of treatment, among the 25 patients, 3 cases (12.00%) were positive for CD133-1 and 22 cases were positive for CD133-2(88.00%)(P<0.05). After chemotherapy, the number of CD133-1 expression in children with B-ALL was significantly reduced, but higher than that in the normal group;while the number of CD133-2 expression was decreased, but the rate of decrease was slower. Conclusion The expression of CD133 in children with acute lymphoblastic leukemia in the first diagnosis is the same as the age, sex, abnormal cytogenetics, FAB subtype, bone marrow immature cell ratio, gene fusion expression, complete remission rate, leukemia risk level. There was no significant correlation between the factors;the expression of CD133-2 in B lymphoblastic leukemia patients was higher than that of CD133-1, and the expression of CD133 was not correlated with the expression of CD34. The expression of CD133-2 was similar to that of minimal residual disease.