摘要
目的:分析错译表达淋系与髓系相关抗原急性白血病(AL)患者异质性生物学特征和预后的相关因素。方法:本院收治的伴有错译表达淋系与髓系相关抗原的AL患者214例,根据其免疫表型进行分组,分析患者异质性生物学特征及预后的影响因素,并通过绘制生存曲线分析患者的生存状况。结果:214例患者中,免疫表型以髓系、B系抗原交叉表达为主(118例),其次是髓系、T系抗原交叉表达(88例),而髓系、T系与B系抗原交叉表达较少(仅有8例)。在急性淋巴细胞白血病(ALL)合并髓系抗原交叉表达的患者中,以CD33为主;在急性髓细胞白血病(AML)合并淋系抗原表达的患者中,T系抗原以CD7为主,而B系抗原以CD19为主。214例患者中,30例CD56和髓系抗原交叉表达; 6例患者为CD7、CD19和CD34交叉表达,4例患者为CD7、CD34和CD56交叉表达。在AML合并淋系抗原表达患者中,重现性染色体异常16例; ALL伴有髓系抗原表达的患者中,重现性染色体异常10例。26例重现性染色体异常的患者均存在错译抗原表达,伴有髓系抗原表达的ALL患者以错译CD33和CD13为多见,而AML伴有淋系抗原表达的患者以错译CD2、CD56及CD19为多见。相比不伴淋系抗原表达的患者,合并错译抗原表达的CD7、CD34阳性者生存率明显降低(均P <0. 05)。经Logistic回归分析结果显示,CD7、CD34是AL患者预后的主要影响因素(均P <0. 05)。结论:存在错译表达淋系与髓系相关抗原的AL是1种特殊白血病,其有着异质性生物学特征及独特的预后特点;临床中可通过流式细胞术对AL免疫表型进行检测,存在错译表达的分化抗原如CD7和CD34等是与AL患者预后相关的主要影响因素。
To analyze the heterogeneous biological characteristics of acute leukemia(AL)patients with mistranslation expressed lymphoid and myeloid-related antigens,and it s prognosis-related factors.Methods:Two hundred and fourteen ALpatiens with mistranslation expressed lymphoid and myeloid-related antigens were grouped according to immunophenotypes,and the heterogeneous biologic charecteristics and prognosis related factors were analyzed,moreover the survival curves were drawn to analyze the survival of patiens.Results:The immunophenotype in 214 cases was mainly cross-expression of myeloid and B lineage antigen(118 cases),followed by cross-expression of myeloid antigen and T lineage(88 cases),while the cross-expression of myeloid,T and B lineages,was less(only 8 cases).In ALL patiens with cross-expression of myeloid antigen,the CD33 was main type;while in AML patients with cross-expression of lymphoid antigen,CD7 was main type of lineage antigen,CD19 was main type of B lineage antigen.Among 214 AL patients,the cross-expression of CD55 and myeloid antigen was found in 30 cases,the cross-expression of CD7,CD19 and CD74 was observed in 6 cases,the cross-expressions of CD7,CD34 and CD56 was detected in 4 cases.Among AML patients with lymphoid antigen expression,the recurrent chromosmal abnormalities were found in 16 cases;among ALL patients with myeloid antigen expression,the recurrent chromosomal abnormalities were observed in 10 cases.The mistranslation antigen expression existed in 26 patients with recurrent chromosomal abnormalities,the mistranslated CD33 and CD13 in ALL patients with myeloid antigen expression was common,while the mistranslated CD2,CD56 and CD19 in AML patients with lymphoid antigen expression was common.As compared with patients without lymphoid antigen expression,the survival rate decreased significantly in patients with mistranslated CD7(+)and CD34(+)(both P<2.25).The logistic regression analysis showed that CD7,CD34 were main influencing factors for prognosis of AL patients(both P<2.25).Conclusion:The AL with mistranslation expressed lymphoid and myeloid antigens is a special kind of leukemia which possesses the heterogeneous biological chaacteristcs and unique prognostic features,thus the immunophemotype of AL patients should be detected by flow cytometry.The existance of mistranlation-expressed differatiation antigens such as CD7 and CD34 is mainly influencing factors for the prognosis of AL patiens.
作者
马琼
何国民
刘红
高晓阳
朱文娟
MA Qiong;HE Guo-Min;LIU Hong;GAO Xiao-Yang;ZHU Wen-Juan(Jangsu Nursing Career Academy,Huaian 22330 1,Jiangsu Province,China;Department of Hematology,Rugao People's Hospital,Rugao 226500,JiangsuProvince,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2018年第5期1263-1268,共6页
Journal of Experimental Hematology
关键词
急性白血病
错译表达
髓系抗原
淋系抗原
生物学特征
临床预后
acute leukemia
mistranslate expression
myeloid antigen
lymphoid antigen
biological characteristic
clinical prognosis
