CD133在小儿急性白血病中的表达及临床意义

摘要

Objective To evaluate the expression of CDl33 and its clinical significance in acute Leukemia (AL) patients. Methods The expression of CDl33 in Leukemic blasts from 100AL patients were detected by flow-cytometry. Results ⑴The pos-itive rates of CDl33 in AL group were 38.0%,which was significantly higher than that in control group. ⑵The positive rates of CDl33 in AML and ALL patients were 40.0%and 37.5%,respectively,and there was no significant difference;The positive rates of CDl33 in T-ALL and B-ALL patients were no significant difference (33.3%,38.0%,respectively). The expression of CD133 in AML subtypes was no significant difference. ⑶The expression of CD133 positive group of complete remission (CR) rate is lower than the expression of CD133 negative groups,the difference was statistically significant. ⑷18 AL cases who were high expression of CD133 and were CR after chemotherapy were followed up,2 AML cases relapse and express high level of CD133 after chemotherapy,including CD133 negative and CD133 persistent expression case,the relapse time were 15 and 12 months after chemotherapy,respectively. 16 ALL cases were negative of CD133 after chemotherapy,5 relapse cases express high level of CD133 again,the relapses time were 21,19,18,16 and 13 months after chemotherapy,respectively. Conclusions AL had signifi-cantly higher CDl33 expression compared to normal control. The detection of CDl33 expression might help to identify AL type and predict therapeutic outcomes;The high expression of CDl33 may be an adverse prognostic factor in AL,CD133 may be a useful marker for MRD in AL.%目的：探讨CD133在急性白血病（AL）患儿中的表达及其意义。方法采用流式细胞术测定100例AL患儿白血病细胞膜上CD133的表达。结果⑴AL组患儿CD133的表达率为38.0%，表达水平显著高于对照组。⑵急性髓细胞白血病（AML）和急性淋巴细胞白血病(ALL)的CD133的表达率分别为40.0%和37.5%，差异无统计学意义，T-ALL和B-ALL的CD133阳性表达率分别为33.3%和38.0%，差异无统计学意义，AML各亚型间CD133阳性表达水平差异无统计学意义。⑶CD133表达阳性组的完全缓解(CR)率低于CD133表达阴性组，差异有统计学意义。⑷对18例初治时CD133高表达经化疗后CR的AL患儿进行随访，2例CD133阳性AML经后续化疗后有1例转阴，1例持续表达，但2例分别在化疗15个月、12个月复发，且转阴患儿骨髓复发时CD133再次表达；16例CD133阳性ALL经后续化疗后均转阴，此后有5例分别在21个月、19个月、18个月、16个月、13个月骨髓复发，且复发时CD133再次表达。结论 AL患儿骨髓细胞CD133表达高于正常对照；检测CD133表达可能有助于AL各亚型的鉴别及疗效判断；CD133高表达可能是AL的一个不良预后因素，以CD133为监测微小残留病灶（MRD）的标记物对防治复发有一定的意义。