急性白血病患儿白血病干细胞表面CD96和CD71的表达对其疗效和预后的影响

发布时间：2018-01-27 04:44

本文关键词： 白血病干细胞 CD CD 急性白血病疗效预后　出处：《吉林大学学报(医学版)》2017年04期 　论文类型：期刊论文

【摘要】：目的:观察白血病干细胞(LSC)表面CD96和CD71表达对急性白血病患儿疗效及预后的影响,阐明白血病患儿LSC的分子生物学特征与其疗效和预后的关联性。方法:选择80例急性白血病患儿作为研究对象,其中急性淋巴细胞白血病(ALL)39例,急性髓系白血病(AML)41例。应用流式细胞术对其LSC表面CD96和CD71表达情况进行检测,对患者的首次化疗疗效、5年生存率、化疗后感染、化疗后复发和髓外浸润发生率进行观察和比较。结果:38例(47.5%)患儿LSC表面CD96阳性表达,45例(56.3%)患儿LSC表面CD71阳性表达,2种抗原阳性表达率比较差异无统计学意义(χ~2=1.227,P=0.268);AML患儿LSC表面CD96和CD71阳性表达率均明显高于ALL患儿(χ~2=22.225,χ~2=34.028,均P0.01)。LSC表面CD96阴性表达患儿首次化疗后的临床有效率和疗效分布均优于LSC表面CD96阳性表达患儿,LSC表面CD71阴性表达的患儿首次化疗后的临床有效率和疗效分布优于LSC表面CD71阳性表达患儿(χ~2=11.323,χ~2=16.589,P0.05;U=2.939,U=2.291,P0.05)。LSC表面CD96阴性表达患儿的5年生存率明显高于LSC表面CD96阳性表达患儿(χ~2=5.051,P0.05),化疗后感染、化疗后复发和髓外浸润发生率明显低于LSC表面CD96阳性表达患儿(χ~2=8.316,χ~2=13.288,χ~2=5.389,均P0.05);LSC表面CD71阴性表达患儿化疗后感染发生率和化疗后复发率明显低于LSC表面CD71阳性表达的患儿(χ~2=6.622,χ~2=10.787,均P0.05)。结论:急性白血病患儿LSC表面的CD96和CD71表达水平与疾病亚型、首次化疗疗效具有一定的关联性,可作为辅助诊断和评价疗效的标志物;CD96的表达水平与患者的预后具有关联性,可作为预测患儿预后的指标。
[Abstract]:Objective: to observe the effect of CD96 and CD71 expression on acute leukemia in children with acute leukemia. Objective: to elucidate the relationship between molecular biological characteristics of LSC and its curative effect and prognosis in children with leukemia. Methods: 80 children with acute leukemia were selected as study subjects. Among them, 39 cases of acute lymphoblastic leukemia (ALL) and 41 cases of acute myeloid leukemia (AMLL) were detected by flow cytometry. The expression of CD96 and CD71 on the surface of LSC was detected by flow cytometry. For the first time chemotherapy, 5-year survival rate, infection after chemotherapy. The incidence of recurrence and extramedullary infiltration after chemotherapy was observed and compared. Results the positive expression of CD96 was found on the surface of LSC in 38 cases of LSC. There was no significant difference in the positive expression rate of CD71 on the surface of LSC between 45 cases (56.3%) and 0.268% (蠂 ~ 2 + 1.227). The positive expression rates of CD96 and CD71 on the surface of LSC in children with AML were significantly higher than those in children with ALL (蠂 2: 22. 225, 蠂 2: 34. 028). The clinical effective rate and curative effect distribution of patients with negative expression of CD96 on the surface of P0.01U 路LSC were better than those of the patients with positive expression of CD96 on the surface of LSC after the first chemotherapy. The clinical effective rate and curative effect distribution of children with CD71 negative expression on LSC surface after first chemotherapy were better than those with CD71 positive expression on LSC surface (蠂 2 + 11.323). 蠂 2 + 16.589 (P 0.05); Uf2. 939, U2. 291. The 5-year survival rate of patients with negative expression of CD96 on the surface of P0.05N 路LSC was significantly higher than that of those with positive expression of CD96 on the surface of LSC (蠂 2 / 5.051 / P0.05). The incidence of infection, recurrence and extramedullary infiltration after chemotherapy was significantly lower than that in children with positive expression of CD96 on the surface of LSC (蠂 2 + 8.316, 蠂 2 + 13.288, 蠂 2 + 5.389). P0.05; The incidence of infection after chemotherapy and recurrence after chemotherapy in children with negative expression of CD71 on the surface of LSC were significantly lower than those with positive expression of CD71 on the surface of LSC (蠂 2 + 6.622). Conclusion: the expression of CD96 and CD71 on the surface of LSC in children with acute leukemia is correlated with the subtype of the disease and the curative effect of the first chemotherapy. It can be used as a marker of auxiliary diagnosis and evaluation of curative effect. The expression of CD96 is correlated with the prognosis of the patients and can be used as a predictor of prognosis.
【作者单位】：吉林大学第一医院小儿肿瘤科;吉林大学第一医院急诊内科;
【基金】：吉林省科技厅科技发展计划项目资助课题(20130486)
【分类号】：R733.71
【正文快照】： 白血病是一种源于造血干细胞的恶性克隆性疾病,急性白血病是多发于儿童的恶性血液疾病,近年来,随着联合化疗、造血干细胞移植等针对白血病治疗方案的不断改进,儿童急性白血病的治疗效果得到了大幅度提升[1-3]。目前,急性淋巴细胞性白血病(acute lymphocytic leukemia,ALL)和急

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