首都医科大学学报 ›› 2006, Vol. 27 ›› Issue (2): 233-236.

• 临床研究 • 上一篇    下一篇

CD7在成人急性髓系白血病的表达及其在微小残留病检测中的应用

李耀华, 徐娟, 孙雪静, 刘聪艳, 万岁桂   

  1. 首都医科大学宣武医院血液科
  • 收稿日期:2005-10-31 修回日期:1900-01-01 出版日期:2006-04-24 发布日期:2006-04-24

CD7 Expression and its Significance in the Detection of Minimal Residual Disease in Adult Acute Myelocytic Leukemia

Li Yaohua, Xu Juan, Sun Xuejing, Liu Congyan, Wan Suigui   

  1. Department of Hematology, Xuanwu Hospital, Capital University of Medical Sciences
  • Received:2005-10-31 Revised:1900-01-01 Online:2006-04-24 Published:2006-04-24

摘要: 目的 观察CD7在成人急性髓系白血病(acute myelocytic leukemia,AML)中的表达情况,并探讨CD7在AML微小残留病灶(minimal residual disease,MRD)检测中的意义.方法 用四色流式细胞术(FCM)分析112例初发的成人AML患者的免疫表型,观察CD7在AML患者骨髓细胞上的表达情况,并将CD7抗体与其他多种髓系抗体(如CD13、CD33、CD117等)构成三色或四色组合,用于CD7+AML患者MRD的检测.结果 112例AML患者中共检测到34例CD7阳性病例,其FAB(French-American-British)亚型分别为:M11例,M2 26例,M3 2例,M4/Ms 5例.所有这些患者的白血病细胞胞质均CD3及CD79a阴性.CD7+组与CD7组间未见明显的年龄及性别差异.CD7与CD34的阳性表达呈显著相关(P=0.002),91.2%的CD7+AML同时伴有CD34的表达.在CD7+AML的MRD检测中,CD7与其他髓系抗原组合能够在双参数散点图上很好地区分白血病细胞与正常细胞.结论 在成人AML中,不同的FAB亚型均可有CD7+病例,其总的阳性率约为30.4%,CD7表达与CD34的表达呈明显的相关性,提示CD7+AML可能起源于一个较早的恶性克隆,CD7抗原阳性也是AML-MRD检测的一个很好指标,为AML-MRD检测率低提供一定的弥补作用.

关键词: 急性髓系白血病, 微小残留病灶, CD7, 流式细胞术

Abstract: Objective To observe the expressions of CD7 in adult acute myelocytic leukemia(AML) and further establish a flow cytometric method for minimal residual disease(MRD) detection.Methods 112 adult patients with AML enrolled in this study.The four-color flow cytometry was used to analyze the characteristics of AML phenotypes.The three or four color fluorochrome labeled monoclonal antibody combinations of CD7 with other myeloid markers,such as CD13,CD33 or CD117,were used to detect MRD.Results 34 of 112 adult patients with CD7+ AML were investigated;they were classified into the following subgroups according to French-American-British(FAB) classification: 1 case M1,26 cases M2,2 cases M3 and 5 cases M4/M5.Leukemia cells from all the patients were negative for cytoplasmic CD3 and CD79a.There was no difference between CD7+ and CD7- AML patients in terms of sex and age.A strong correlation between CD7 and CD34 expression was also observed and 91.2% CD7+ AML cases co-expressed the CD34 antigen.In the MRD detection of CD7+ AML,CD7,combined with other myeloid markers,could effectively distinguish normal cells from leukemia cells in the dual-parameter dot plots.Conclusion CD7 expression could be detected in all the FAB subtypes of adult AML and the total positive percentage was 30.4%.The strong correlation between CD7 and CD34 expression suggested the CD7+ AML might be derived from a more immature malignant clone.The combination of CD7 and other myeloid markers could be applied to monitor the MRD and significantly improve the detection sensitivity in adult AML.

Key words: acute myelocytic leukemia, minimal residual disease, CD7, flow cytometry

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