摘要
目的分析急性髓系白血病幼稚细胞群免疫表型特点和预后。方法选取2012年3月—2016年3月湖北省十堰市太和医院血液内科治疗的急性髓系白血病患者384例作为研究对象,采用多色流式细胞术和相关的单克隆抗体对所有患者的骨髓免疫表型进行分析;根据淋系抗原(LymAg)表达将患者分为LymAg(+)组(184例)和LymAg(-)组(200例),观察2组患者的临床特征。颗粒增多的早幼粒细胞白血病(M3)患者采用全反式维甲酸(ATRA)治疗,其余患者均采用DA(柔红霉素+阿糖胞苷)方案或者IDA(去甲氧柔红霉素+阿糖胞苷)方案诱导化疗,治疗2个疗程,观察并记录分析患者的完全缓解率(CR)。结果 AML.患者髓系抗原表达主要有CD13、CD33和MPO,阳性率分别为96.6%、91.9%和83.9%,其中有47.9%的患者伴有淋系抗原表达,主要有CD7和CD56,阳性率分别为32.0%和20.8%,其次为CD19和CD2,阳性率分别为10.2%和7.6%;LymAg(+)组肝/脾大患者的比例与LymAg(-)组相比差异有统计学意义(42.9%vs.13.0%,×2=10.362,P=0.000);CD7^+患者的GR与CD7^-患者相比差异有统计学意义(37.4%vs.83.9%,χ~2=4.907,P=0.032)。结论免疫分型对AML的诊断、治疗和预后有重要意义,可为临床研究提供依据。
Objective To investigate the immunophenotype characteristics of acute myeloid leukemia and analysis of the immune phenotype.Methods Immunophenotyping of 384 patients was performed by flow cytometry using a panel of monoclonal antibodies.According to the expression of lymAg,the patients were divided into lymAg（＋） group and lymAg（-） group,the clinical features of the two groups were observed.M3 patients with all trans retinoic acid（ATRA） treatment,and the rest patients were using DA or IDA to induce chemotherapy for two courses,observed and recorded patients＇ CR.Results AML patients with myeloid antigen expression are mainly CD13,CD33 and MPO,the positive rates were 96.6%,91.9%and 83.9%,of which 47.9%patients with lymphoid antigen expression,mainly CD7 and CD56,the positive rates were 32.0%and 20.8%,followed by CD19 and CD2,the positive rates were 10.2%and 7.6%;LymAg（＋） group＇s the proportion of patients with liver/splenomegaly was statistically significant difference compared to LymAg（-） group（42.9%vs.13.0%,χ~2=10.362,P=0.000）;CD7~＋ CR patients compared with CD7^- patients had significant difference（37.4%vs.83.9%,χ~2=4.907,P=0.032）.Conclusion The diagnosis,treatment and prognosis of AML are of great significance,which can provide a basis for clinical research.
出处
《疑难病杂志》
CAS
2016年第12期1250-1254,共5页
Chinese Journal of Difficult and Complicated Cases
