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中华危重症医学杂志(电子版)

中华危重症医学杂志(电子版) ›› 2018, Vol. 11 ›› Issue (01) : 35 -40. doi: 10.3877/cma.j.issn.1674-6880.2018.01.006

所属专题： 文献；

论著

急性髓样白血病干细胞CD200的表达及与疗效的相关分析
郑晓燕1, 贺超奇2, 陈芳建1, 黄卉1, 吴芬芝3, 詹碧翠4,†()   
  1. 1. 324000　浙江衢州，衢州市人民医院检验科
    2. 311200　杭州，杭州市萧山区第一人民医院检验科
    3. 324000　浙江衢州，衢州市人民医院血液科
    4. 310014　杭州，杭州市中医院检验科
  • 收稿日期:2017-06-20 出版日期:2018-02-01
  • 通信作者: 詹碧翠
  • 基金资助:
    浙江省科技厅公益技术研究社会发展项目(2013C33SA100139); 杭州市科技局项目(20140633B50); 衢州市科技局项目(2015064)

Expression of CD200 in acute myeloid leukemia stem cells and its correlation with clinical efficacy

Xiaoyan Zheng1, Chaoqi He2, Fangjian Chen1, Hui Huang1, Fenzhi Wu3, Bicui Zhan4,†()   

  1. 1. Department of Clinical Laboratory, Quzhou People's Hospital, Quzhou 324000, China
    2. Department of Clinical Laboratory, the First People's Hospital of Xiaoshan District, Hangzhou 311200, China
    3. Department of Hematology, Quzhou People's Hospital, Quzhou 324000, China
    4. Department of Clinical Laboratory, Hangzhou Chinese Medicine Hospital, Hangzhou 310014, China
  • Received:2017-06-20 Published:2018-02-01
  • Corresponding author: Bicui Zhan
  • About author:
    Corresponding author: Zhan Bicui, Email:
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郑晓燕, 贺超奇, 陈芳建, 黄卉, 吴芬芝, 詹碧翠. 急性髓样白血病干细胞CD200的表达及与疗效的相关分析[J]. 中华危重症医学杂志(电子版), 2018, 11(01): 35-40.

Xiaoyan Zheng, Chaoqi He, Fangjian Chen, Hui Huang, Fenzhi Wu, Bicui Zhan. Expression of CD200 in acute myeloid leukemia stem cells and its correlation with clinical efficacy[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2018, 11(01): 35-40.

目的

探究急性髓样白血病（AML）患者白血病干细胞（LSCs）中CD200的表达以及其与临床疗效的相关性。

方法

收集2014年4月至2017年4月衢州市人民医院收治的137例AML患者，进行AML分型，分为M1~M5型。并对患者临床疗效进行统计，分为三组：完全缓解（CR）组（59例）、部分缓解（PR）组（47例）和未缓解（NR）组（31例）。通过流式细胞仪分离患者治疗前后的骨髓LSCs，检测LSCs表达、CD200在LSCs中的表达水平。

结果

24.82%（34/137）AML患者的LSCs中表达CD200，且CD200在AML各亚型中表达的阳性占比的比较，差异有统计学意义（5/11、13/26、4/35、3/22、9/43，χ2=16.533，P=0.002）。AML-LSCs在AML各亚型中都存在高表达，且差异无统计学意义（F=0.980，P=0.421）；除CD200在M3组的LSCs中呈现更低表达外[（10.1 ± 2.7）%]，其在AML其他各亚型中表达差异均无统计学意义[（16.5 ± 2.8）%、（19.7 ± 4.0）%、（16.4 ± 2.4）%、（17.0 ± 3.1）%，P均> 0.05]。而在治疗疗效观察中，治疗前CD200在LSCs中的表达水平在CR、PR、NR三组间比较，差异均无统计学意义（P均> 0.05）；治疗后随着症状的缓解程度提高，各组CD200在LSCs中表达水平也随之降低[（16.4 ± 3.6）%、（10.8 ± 2.6）%、（5.0 ± 1.8）%，P均< 0.05]。治疗后，CR与NR两组CD200阳性表达占比的比较，差异有统计学意义（5/59 vs. 14/31，P < 0.017）；同时AML亚型分组中M3组内的CR、PR、NR三组CD200+/CD200-分布情况的比较，差异有统计学意义（0/22、1/11、1/0，χ2=17.786，P < 0.001）。

结论

AML患者LSCs中高表达CD200与不良预后有一定关系，可影响临床疗效。

关键词: 白血病，髓样，急性, CD200, 临床疗效
Objective

To investigate the expression of CD200 in leukemia stem cells (LSCs) from the patients with acute myeloid leukemia (AML) and its correlation with clinical efficacy.

Methods

A total of 137 AML patients admitted to Quzhou People's Hospital from April 2014 to April 2017 were collected and divided into M1-M5 types, according to AML classification. Based on the clinical efficacy, AML patients were also statistically divided into three groups: complete remission (CR) group (n=59), partial remission (PR) group (n=47) and non-remission (NR) group (n=31). The flow cytometry was used for separating bone marrow LSCs and detecting the expressions of LSCs and CD200 in LSCs before and after treatment.

Results

24.82% (34/137) AML patients had CD200 expression in LSCs, while the positive proportions of CD200 expression in each subtype of AML were significantly different (5/11, 13/26, 4/35, 3/22, 9/43; χ2=16.533, P=0.002). AML-LSCs had high expressions in all AML subtypes, which showed no significant difference (F=0.980, P=0.421); except that the expression of CD200 in the LSCs was obviously lower in the M3 group [(10.1 + 2.7)%], the CD200 expressions were no difference in the other AML subtypes [(16.5 ± 2.8)%, (19.7 ± 4.0)%, (16.4 ± 2.4)%, (17.0 ± 3.1)%, all P > 0.05]. The treatment effect observation showed that the expressions of CD200 in the LSCs were not statistically significantly different among CR, PR and NR groups before treatment (all P > 0.05); the expression of CD200 in the LSCs decreased with the improvement of symptoms after treatment [(16.4 ± 3.6)%, (10.8 ± 2.6)%, (5.0 ± 1.8)%, all P < 0.05]. There was a significant difference of CD200 positive expression between CR and NR groups after treatment (5/59 vs. 14/31, P < 0.017); in addition, the comparison of CD200+/CD200- in CR, PR, NR subgroups of AML M3 group was significantly different (0/22, 1/11, 1/0; χ2=17.786, P < 0.001).

Conclusion

The high expression of CD200 in LSCs of AML patients has a certain relationship with poor prognosis, which can affect the clinical efficacy.

Key words: Leukemia, myeloid, acute, CD200, Clinical efficacy
表1 AML初诊患者治疗前LSCs及CD200表达水平的比较（±s）
AML亚型组 例数 CD200阳性表达占比 AML-LSCs表达水平（%） CD200在LSCs中表达水平（%）
M1组 11 5/11 78 ± 16 16.5 ± 2.8b
M2组 26 13/26a 80 ± 20 19.7 ± 4.0b
M3组 35 4/35 73 ± 18 10.1 ± 2.7
M4组 22 3/22 83 ± 23 16.4 ± 2.4b
M5组 43 9/43 80 ± 18 17.0 ± 3.1b
χ2/F值 ? 16.533 0.980 5.001
P值 ? 0.002 0.421 0.003
表2 三组疗效分组患者治疗前后CD200在LSCs中表达水平的比较（±s）
疗效分组 例数 CD200在LSCs中的表达水平（%）
治疗前 治疗后
CR组 59 13.8 ± 1.9a 5.0 ± 1.8
PR组 47 16.0 ± 2.5b 10.8 ± 2.6a
NR组 31 16.8 ± 3.8 16.4 ± 3.6ab
F值 ? 15.750
P值 ? < 0.001
表3 AML初诊患者治疗后各亚型中CD200+/CD200-在CR、PR、NR组中分布情况（例）
疗效分组 例数 AML亚型组
M1组 M2组 M3组 M4组 M5组
CR组 59 1/4 2/9 0/22 1/9 1/10
PR组 47 1/3 2/5 1/11 1/5 6/12
NR组 31 1/1 4/4 1/0 2/4 6/8
χ2值 ? 0.665 2.223 17.786 1.385 3.471
P值 ? 0.717 0.329 < 0.001 0.500 0.176
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