LILRB1和LILRB4在单核细胞分化急性髓系白血病诊断中的意义

Significance of LILRB1 and LILRB4 in the diagnosis of monocyte-differentiated acute myeloid leukemia

目的:探讨LILRB1和LILRB4在单核细胞分化急性髓系白血病(M-AML)诊断中的意义。方法:通过直接荧光标记流式细胞术检测109例急性白血病患者白血病细胞LILRB1、LILRB4、CD64和CD14的表达。结果:LILRB1在M-AML、NM-AML和ALL患者中表达阳性率分别为81.6%(31/38)、0(0/49)、27.3%(6/22),差异有统计学意义(P<0.01),其中M-AML组的阳性率明显高于NM-AML组和ALL组,ALL组阳性率明显高于NM-AML组;LILRB4在M-AML组中的表达阳性率为81.6%(31/38),在NM-AML和ALL组中均不表达(0/49,0/22),差异有统计学意义(P<0.01);单独检测LILRB1、LILRB4诊断M-AML敏感性均为81.6%,联合检测的敏感性为86.8%,特异性均为100%,优于CD64(86.8%,61.2%)、CD14(31.6%,100%)。结论:LILRB1、LILRB4单独检测或联合检测对检出M-AML均具有极高的灵敏度和特异度,可作为诊断M-AML的新指标。

Objective:To explore the significance of LILRB1 and LILRB4 in the diagnosis of monocyte-differentiated acute myeloid leukemia(M-AML).Methods:Flow cytometry with direct immunofluorescence staining was used to detect the expression of LILRB1,LILRB4,CD64 and CD14 of 109 acute leukemia patients.Results:There was statistical difference in the positive rate of LILRB1 among M-AML,NM-AML and ALL(81.6%,0,27.3%,P<0.01).The positive rate of M-AML group was significantly higher than that of NM-AML group and ALL group,and the positive rate of ALL group was significantly higher than that of NM-AML group.The positive rate of LILRB4 in M-AML group was 81.6%(31/38),but LILRB4 was not expressed in both NM-AML and ALL groups(0/49,0/22),which has statistical difference(P<0.01).The sensitivity of individual detection of LILRB1 and LILRB4 in diagnosing M-AML was 81.6%,while the sensitivity of combined detection was 86.8%,and the specificity was 100%,which was better than CD64(86.8%,61.2%),CD14(31.6%,100%).Conclusion:Both LILRB1,LILRB4 alone or in combination have high sensitivity and specificity for detecting M-AML,which can be used as new indicators for the diagnosis of M-AML.