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为了探讨基质细胞衍生因子-1α(stromal cell derived factor-1α,SDF-1α)及其受体CXCR4在急性粒细胞、单核细胞、淋巴细胞三系白血病的表达及与髓外浸润的关系,对66例急性白血病中的急性淋巴细胞白血病(ALL)患者组(31例)、急性粒细胞白血病(M2)患者组(20例)、急性单核系细胞白血病(M4+M5)患者组(15例)、髓外浸润患者组(41例)、非髓外浸润患者组(25例),应用酶联免疫吸附实验(ELISA)及流式细胞术分别检测SDF-1α及其受体CXCR4在三组白血病外周血及骨髓白血病细胞上的表达。结果表明:ALL患者组、M4+M5患者组、M2患者组及正常对照组血浆的SDF-1α水平分别为1317.87±220.76,1339.79±187.06,1063.70±190.74,1908.34±135.55(pg/ml),其中ALL患者和M4+M5患者组高于M2患者组,但均明显低于正常对照组(P<0.01)。髓外浸润患者组及非髓外浸润患者组SDF-1α血浆水平分别为1252.49±263.12、1234.91±185.50,(pg/ml),组间无显著差别。CXCR4在ALL患者组、M4+M5患者组、M2患者组白血病细胞上表达的平均荧光强度(MFI)为78.47±33.96、67.21±24.29、41.66±17.18,ALL患者组及M4+M5患者组明显高于M2患者组(P<0.05)。ALL患者组、M4+M5患者组间无显著性差别。髓外浸润患者组CXCR4表达的MFI(81.72±27.63)明显高于非髓外浸润患者组(36.94±11.86)(P<0.05)。结论:急性淋巴细胞、单核细胞系白血病细胞趋化因子受体CXCR4高表达可能是其易发生髓外浸润的分子机制,3组白血病患者外周血SDF-1α表达水平均降低且与髓外浸润无明显相关,髓外浸润可能更取决于受浸润脏器局部SDF-1α表达水平。
To investigate the relationship between the expression of stromal cell derived factor-1α (SDF-1α) and its receptor CXCR4 in acute granulocytic, monocytic and lymphocytic leukemia and its relationship with extramedullary infiltration 66 cases of acute leukemia in patients with acute lymphoblastic leukemia (ALL) (31 cases), acute myeloid leukemia (M2) patients (20 cases), acute monocytic leukemia (M4 + M5) patients (15 cases ), Extramedullary infiltration group (41 cases) and non-extramedullary infiltration group (25 cases). The levels of SDF-1α and its receptor CXCR4 were detected by enzyme-linked immunosorbent assay (ELISA) and flow cytometry in three groups Leukemia peripheral blood and myeloid leukemia cells. The results showed that the plasma levels of SDF-1α in ALL patients, M4 + M5 patients, M2 patients and normal controls were 1317.87 ± 220.76, 1339.79 ± 187.06, 1063.70 ± 190.74 and 1908.34 ± 135.55 (pg / ml), respectively Patients with ALL and those with M4 + M5 were significantly higher than those with M2, but both were significantly lower than those in the control group (P <0.01). The plasma levels of SDF-1α in patients with extramedullary infiltration and non-extramedullary infiltration were 1252.49 ± 263.12, 1234.91 ± 185.50 and (pg / ml), respectively, with no significant difference between the two groups. The average fluorescence intensity (MFI) of CXCR4 on ALL patients, M4 + M5 patients and M2 patients was 78.47 ± 33.96,67.21 ± 24.29 and 41.66 ± 17.18, respectively. The patients with ALL and M4 + M5 had significantly higher MFI In M2 patients (P <0.05). There was no significant difference between ALL patients and M4 + M5 patients. The MFI of CXCR4 expression in extramedullary infiltration group (81.72 ± 27.63) was significantly higher than that in non-extramedullary infiltration group (36.94 ± 11.86) (P <0.05). Conclusion: The high expression of chemokine CXCR4 in acute lymphocytic and monocytic leukemia cells may be the molecular mechanism of its susceptibility to extramedullary infiltration. The expression of SDF-1α in peripheral blood of three leukemia patients is decreased and the extramedullary infiltration No significant correlation between extramedullary infiltration may be more dependent on the local infiltration of SDF-1α expression of organs.