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目的探讨肿瘤干细胞分化抗原CD133的表达与急性白血病患者临床特征的关系。方法 90例初治急性白血病患者,急性髓细胞白血病(AML)患者60例,急性淋巴细胞白血病(ALL)患者30例,对所有的患者骨髓进行流式细胞术进行免疫分型及检测CD133的表达,同时采用高分辨溶解曲线技术(HRM)和变性高效液相色谱技术(DHPLC)检测AML患者的FLT3-ITD和NPM1基因突变,所有患者常规进行外周血WBC、Hb和PLT,以及骨髓象的检测,分析AML和ALL的临床特征以及常见的预后指标与CD133表达关系,以及AML患者CD133的表达与FLT3-ITD与NPM1基因突变的关系。结果 AML患者CD133阳性率60%,ALL患者CD133阳性率为40%。CD133阳性表达者,肝脏、脾脏肿大的发生率两组急性白血病均高于阴性表达(P<0.05);而在AML患者,骨痛发生率阳性表达CD133者为77.8%,显著高于阴性表达者(P<0.05)。在AML组患者中,CD133表达与WBC计数呈现正相关(P<0.01)。AML患者NPM1突变型占35%,FLT3-ITD突变型占30%,FLT3-ITD突变组CD133阳性表达率高于FLT3-ITD野生型组(P<0.05);而NPM1基因突变组与野生型组CD133的表达无统计学差异(P>0.05)。结论白血病细胞CD133的表达与急性白血病常见预后指标、以及FLT3-ITD突变密切相关,有可能成为急性白血病预后不良的指标。
Objective To investigate the relationship between the expression of tumor stem cell differentiation antigen CD133 and the clinical features of patients with acute leukemia. Methods 90 patients with newly diagnosed acute leukemia, 60 patients with acute myeloid leukemia (AML) and 30 patients with acute lymphoblastic leukemia (ALL), all patients were subjected to immunophenotyping and CD133 expression by flow cytometry , FLT3-ITD and NPM1 gene mutations in AML patients were detected by HRM and DHPLC, and peripheral blood WBC, Hb, PLT, and bone marrow were detected routinely in all patients . The clinical features of AML and ALL were analyzed. The relationship between the expression of CD133 and the expression of CD133 and the relationship between FLT3-ITD and NPM1 gene mutations in AML patients were analyzed. Results The positive rate of CD133 in AML patients was 60% and the positive rate of CD133 in ALL patients was 40%. The incidence of hepatocellular and splenomegaly in patients with CD133 positive expression was higher than that in patients with acute leukemia (P <0.05), but in patients with AML, the incidence of bone pain was significantly higher than that of negative expression of CD133 (77.8%) (P <0.05). Among AML patients, CD133 expression was positively correlated with WBC count (P <0.01). The positive rate of CD133 in FLT3-ITD mutant group was higher than that in FLT3-ITD wild-type group (P <0.05), while NPM1 mutation group was 35%, FLT3-ITD mutation group was 30% There was no significant difference in the expression of CD133 (P> 0.05). Conclusions The expression of CD133 in leukemia cells is closely related to the common prognosis indicators of acute leukemia and FLT3-ITD mutation, and may be an indicator of poor prognosis in acute leukemia.