CD47 在急性白血病干细胞中的表达及其对临床疗效及预后的影响

目的:探讨CD47在急性白血病患者骨髓白血病细胞的表达及其临床意义。方法:选择2013年5月-2015年5月在我院确诊的急性白血病患者101例作为研究对象,其中急性淋巴细胞白血病50例(ALL组),急性髓系白血病51例(AML组)。另选取同期在我院接受体检的健康志愿者39例作为对照组。采用流式细胞仪检测白血病细胞表面CD47的表达情况,并分析CD47表达与急性白血病患者临床疗效及复发情况的关系。结果:急性白血病患者白血病细胞CD47的阳性表达率明显高于健康对照组,差异具有统计学意义(P0.05);而ALL组与AML组患者白血病细胞CD47的阳性表达率比较差异无统计学意义(P0.05);CD47阴性表达的急性白血病患者CR率显著高于阳性表达者,差异具有统计学意义(P0.05);ALL组和AML组CD47阴性表达患者CR率显著高于CD47阳性表达患者,差异具有统计学意义(P0.05),但两组之间比较,差异无统计学意义(P0.05);CD47阳性表达的急性白血病患者复发率显著高于阴性表达患者,差异具有统计学意义(P0.05);ALL组和AML组CD47表达阳性患者复发率明显高于阴性患者,差异具有统计学意义(P0.05),但两组之间比较差异无统计学意义(P0.05)。结论:急性白血病患者白血病细胞表面CD47的表达异常升高,且与白血病患者的疗效和预后有关,CD47可能作为一种急性白血病的诊断及疗效和预后的辅助评估指标。

Expression of CD47 in Patients with Acute Leukemia and Its Effects on the Clinical Efficacy and Prognosis

Objective:To explore the expressions of CD47 in patients with acute leukemia (AL) and the evaluation of curative effect and prognosis. Methods:101 cases with AL who were diagnosed in our hospital from May 2013 to May 2015 were selected which including 50 cases with acute lymphoblastic leukemia (ALL group) and 51 cases with acute myeloid leukemia (AML group). Another 39 healthy volunteers who had taken the physical examination in our hospital were selected to be the control group. Then the expressions of CD47 in leukemia cells were detected by the flow cytometry. And the relationships of CD47 expression with the complete remission rate (CR) and recurrence rate of AL patients were analyzed statistically.Results:The positive expression rate of CD47 in patients with acute leukemia was significantly higher than that of patients in control group, and the difference was statistically significant (P<0.05); There was no statistically significant difference about the positive expression rate of CD47 in ALL group and AML group (P>0.05); CR of patients with negative expression of CD47 was significantly higher than that of the patients with positive expression of CD47, and the difference was statistically significant (P<0.05); CR of patients with negative expression of CD47 in ALL group and AML group was significantly higher than that of the patients with positive expression of CR, and the difference was statistically significant (P<0.05); There was no significant difference between the two groups (P>0.05); The recurrence rate of patients with CD47 positive expression was significantly higher than that of patients with negative expression, and the difference was statistically significant (P<0.05); The recurrence rate of patients with CD47 positive expression in ALL group and AML group was significantly higher than that of patients with negative expression, and the difference was statistically significant (P<0.05); There was no significant difference between the two groups (P>0.05).Conclusion:The expression of CD47 increased specifically in the surface of acute leukemia cells, which can reflect the therapeutic effect and prognosis of acute leukemia, so it can be used as a standard for clinical diagnosis.