CD34抗原在小儿急性白血病中的表达及其临床意义

发布时间：2018-03-09 14:59

本文选题：急性白血病　切入点：CD34　出处：《宁夏医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的探讨CD34抗原在小儿急性白血病（AL）中的表达与临床表现及化疗疗效的关系。方法采用流式细胞术分别检测85例急性淋巴细胞白血病（ALL）及42例急性髓系白血病（AML）初诊患儿骨髓CD34的表达阳性率，比较ALL和AML患者CD34表达的差异。观察AL患者临床特征与疗效，比较CD34表达与非CD34表达患者临床表现差异和治疗效果。结果1.85例ALL患儿CD34阳性率为43.52%，42例AML患儿CD34阳性率为47.61%，AML组CD34表达略高于ALL组(P0．05)，但无统计学差异。2..CD34在AML-M3亚型中为低表达或不表达，有统计学意义；CD34在ALL-L3型中为低表达，，但统计学分析无意义。3.在AL预后因素分析中，CD34的阳性表达率与性别、外周血白细胞计数、血红蛋白浓度、血小板数量等无明显差异；但在ALL患儿中肿瘤浸润(肝脾、淋巴结肿大)表现上有统计学差异（X2=3.99，P=0.046），而在AML中肝脾淋巴结肿大等征象上均无明显差异。4.含CD34的表达的ALL在诱导治疗4周的缓解率上无统计学差异（P0.05）；AML患儿在诱导化疗疗效方面，CD34+组完全缓解率为35.0%，明显低于CD34-组的72.72%（X2=6.019，P=0.014）,5.AML细胞CD34的过度表达是AML预后不良因素之一。结论AML患者骨髓细胞CD34表达略高于ALL组。CD34在AML-M3亚型中为低表达或不表达；AML组CD34的表达与性别、外周血白细胞数、血红蛋白浓度、血小板数量及肿瘤浸润(肝脾，淋巴结肿大)等表现上无相关性；其在诱导4周化疗后完全缓解率上与CD34抗原表达阴性者相比有统计学意义。CD34在ALL-L3型中表达较其他亚型低，ALL组CD34表达与性别、外周血白细胞数、血红蛋白浓度、血小板数量等无明显相关性；但肝脾，淋巴结肿大等肿瘤浸润等临床征象上有统计学差异；而在诱导治疗4周的缓解率上差异无明显相关性。CD34抗原表达可能是AML的一个预后不良因素。
[Abstract]:Objective to investigate the expression of CD34 antigen in children with acute leukemia. Methods the positive rates of bone marrow CD34 expression in 85 cases of acute lymphoblastic leukemia (ALL) and 42 cases of acute myeloid leukemia (AMLL) were detected by flow cytometry. To compare the difference of CD34 expression between ALL and AML patients, to observe the clinical characteristics and curative effect of AL patients, to compare the clinical manifestations and therapeutic effects between CD34 expression and non-#en4# expression. Results 1.The positive rate of CD34 in 85 cases of ALL was 43.52%. The positive rate of CD34 in 42 cases of AML was 47.61%. The expression of CD34 was slightly higher in group A than that in group ALL (P 0.05), but there was no statistical difference in the expression of CD34 in AML-M3 subtype, but the expression of CD34 was low in ALL-L3 type. However, there was no significant difference between the positive expression rate of CD34 and sex, peripheral white blood cell count, hemoglobin concentration and platelet count in the prognostic factor analysis of AL, but there was no significant difference in tumor infiltration (liver and spleen, liver and spleen) in children with ALL. There was statistical difference in the manifestation of lymphadenopathy. There was no significant difference in the signs of hepatosplenomegaly in AML. 4. There was no significant difference in remission rate of ALL with CD34 expression in 4 weeks of induction treatment. In terms of therapeutic effect, the complete remission rate of CD34 group was 35.0, which was significantly lower than that of CD34- group (72.72%). The overexpression of CD34 in AML cells was one of the factors contributing to the poor prognosis of AML. Conclusion the expression of CD34 in bone marrow cells of AML patients is slightly higher than that in ALL group. CD34 expression and sex, peripheral white blood cell count, hemoglobin concentration, platelet count and tumor infiltration (liver and spleen) are lower or not in AML-M3 subtype. The expression of CD34 in ALL-L3 group was lower than that in other subtypes, the expression of CD34 and sex, the number of peripheral blood leukocytes, and the number of peripheral blood leukocytes in all group were significantly lower than those in other subtypes, and the complete remission rate after 4 weeks of chemotherapy was significantly higher than that in patients with negative expression of CD34 antigen, and the expression of CD34 was significantly lower in ALL-L3 type than in other subtypes. There was no significant correlation between hemoglobin concentration and platelet count, but there were statistical differences in clinical signs such as liver and spleen, lymph node enlargement and tumor infiltration. However, there was no significant correlation between the remission rate of induced therapy and 4 weeks of treatment. The expression of CD34 antigen may be a poor prognostic factor in AML.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R733.71

【参考文献】