摘要
目的:探讨伴CD4、CD7表达的AML病人免疫分型特点及分子生物学和细胞遗传学特征。方法:应用四色流式细胞术,以CD45设门,检测304例病人白血病细胞的免疫表型;RT-PCR方法检测WT1、MDK、ETO、PMLRaRa、BCR-ABL分子生物学标志;R显带技术分析白血病细胞核型变化。根据免疫分型结果,将病人分为3组:伴CD7表达的AM L组,伴CD4表达的AM L组(CD4组),无T系抗原表达的AM L组(common AM L组)。结果:CD7组患者HLA-DR表达率和表达量均高于无T系抗原表达AM L组,CD34、CD33表达率高于无T系抗原表达AM L组和CD4组;CD4组患者CD15、CD64的表达率和表达量均高于CD7组和无T系抗原表达AM L组,CD33表达率、表达量高于无T系抗原表达AML组,差异有统计学意义(P<0.05);CD7组患者WT1表达低于无T系抗原表达AML组,差异有统计学意义(P<0.05),在CD7组患者未发现PML-RaRa表达。伴有CD4、CD7表达的AM L组正常核型的比例高于无T系抗原表达AM L组。伴有CD7表达的AM L患者中无1例发生t(15;17)。结论:伴有CD7表达的AML的白血病细胞来源于前体细胞,被阻滞在造血发育的早期阶段;伴有CD4表达的AML白血病细胞起源于相对成熟的阶段,高表达CD33、CD64、CD15;伴有CD7、CD4表达的AML无特异性的细胞遗传学改变。根据CD4、CD7的表达量和强度,联合髓系标志可定量检测AML病人MRD。
Objective：To explore the features of immunophenotypes and the characteristics of molecular biology and cellular genetics of AML patients with CD7 and CD4 expression.Methods：The immunophenotypical markers of AML cells were detected by multiple parameter flow cytometry;the expression of WT1,MDK,ETO,PML-RaRa and BCRABL were detected by RT-PCR;and cellular features were analyzed by R-band in 304 patients.The patients were divided into three groups according to their immunophenotypes：AML with CD7 expression（CD7 group）,AML with CD4expression（CD4 group） and AML without CD7 and CD4 expression（common AML group）.Results：The expression rate and level of HLA-DR in CD7 group were higher than those in the common AML group,and the expression rate of CD33 and CD34 was higher than that in the other two groups.The expression rate and level of CD15,CD64 in the CD4 group were higher than those in the other 2 groups,and the expression rate and level of CD33 were higher than those in the common AML group.WT1 expression in the CD7 group was lower than that in the common AML group.PML-RaRa was not detected in the CD7 group.AML with co-expression of CD4 or CD7 showed more normal karyotype.（15;17）was not found in AML with CD7 expression.Conclusion：AML cells with CD7 expression originate from precursor cells and are blocked in the early phase of hematological development;AML cells with CD4 expression originate from more mature stage of hematological devevelopment and with CD33,CD64 and CD15 high expression;AML cells with CD7 and CD4 expression are characterized by no- specific change of cellular genetics.According to the expression level and intesity of CD4 and CD7,and together with other specific lineage markers,the MRD in AML patients can be quantitatively detected.
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2016年第6期1627-1632,共6页
Journal of Experimental Hematology
