淋系抗原表达对急性髓系白血病预后的价值

Prognostic analysis of lymphoid antigen expression in acute myeloid leukemia

目的:探讨淋系抗原表达在急性髓系白血病(acute myeloid leukemia,AML)预后方面的临床意义。方法:应用流式细胞术检测我院101例初诊AML患者的免疫表型,以CD7^(-)CD19^(-)CD56^(-)AML为对照组,将CD7^(+)AML组、CD19^(+)AML、CD56^(+)AML组与对照组的临床特征、疗效进行分析比较,随访并观察生存曲线的差异。结果:101例AML患者中淋系抗原表达者52例(51.5%),CD7抗原表达29例(28.7%),CD56抗原表达29例(28.7%),CD19抗原表达13例(12.8%);CD7^(+)AML、CD19^(+)AML、CD56^(+)AML患者与对照组间的发病年龄、肝脾大、髓外浸润、白细胞计数、血红蛋白、骨髓原始细胞比例差异无统计学意义(P>0.05),CD7^(+)AML组血小板计数偏低(P<0.05);CD56^(+)AML组首次完全缓解率(CR)率及总CR率均低于对照组(P<0.05);CD7^(+)AML、CD19^(+)AML组首次CR率及总CR率与对照组相比差异均无统计学意义(P>0.05);与对照组相比,CD56^(+)AML组无复发生存期(RFS)缩短(P<0.05),CD7^(+)AML、CD19^(+)AML组RFS与对照组差异无统计学意义(P>0.05)。结论:CD56^(+)AML患者常规化疗不敏感,疗效差,CD56抗原可能是AML患者的预后不良因素;CD7、CD19抗原不影响AML患者的预后。

Objective:To explore the clinical significance of lymphoid antigen expression in the prognosis of acute myeloid leukemia(AML).Methods:Flow cytometry was used to detect the immunophenotype of 101 newly diagnosed AML patients in our hospital.CD7^(-)CD19^(-)CD56^(-)AML was used as the control group.The CD7^(+)AML group,CD19^(+)AML,CD56^(+)AML group were compared with the control group.Clinical characteristics and efficacy were compared.The difference in survival curves was followed up and observed.Results:In 101 patients with AML,52(51.5%)had lymphoid system antigen expression,29 had CD7 antigen expression(28.7%),29 had CD56 antigen expression(28.7%),and 13 had CD19 antigen expression(12.8%).There was no statistically significant difference in the age of onset,hepatosplenomegaly,extramedullary infiltration,white blood cell count,hemoglobin,and bone marrow blast cells between patients with CD7^(+)AML,CD19^(+)AML,and CD56^(+)AML(P>0.05),CD7^(+)AML group platelet count in CD7^(+)AML group was low(P<0.05).The first complete remission rate(CR%)and total CR rate in the CD56^(+)AML group were lower than those in the control group(P<0.05).CD7^(+)AML,CD19^(+)AML group had no significant difference in the first CR rate and total CR rate compared with the control group(P>0.05).Compared with the control group,recurrence-free surviral(RFS)in CD56^(+)AML group shortened(P<0.05).RFS of CD7^(+)AML,CD19^(+)AML group had no statistical difference with control group(P>0.05).Conclusion:CD56^(+)AML patients are insensitive to conventional chemotherapy and have poor efficacy.CD56 antigen may be a poor prognostic factor in AML patients.CD7 and CD19 antigens do not affect the prognosis of AML patients.