CD123和CD66c在儿童B-ALL中的表达及其在MRD监测中的应用

doi:10.3969/j.issn.1673-8640.2018.09.008

检验医学 ›› 2018, Vol. 33 ›› Issue (9): 807-810.DOI: 10.3969/j.issn.1673-8640.2018.09.008

CD123和CD66c在儿童B-ALL中的表达及其在MRD监测中的应用

钟嘉颖¹, 吴英英¹, 劳梦晓¹, 张小艳¹, 王春丽², 潘建华²

1.广州医科大学,广东广州 510182
2.广州金域医学检验中心临床血液流式细胞检测中心,广东广州 510005

收稿日期:2017-08-17 出版日期:2018-09-30 发布日期:2018-10-13
作者简介:null
作者简介：钟嘉颖,女,1996年生,学士,主要从事急性淋巴细胞白血病微小残留病监测研究。

Expressions of CD123 and CD66c in childhood B-cell acute lymphoblastic leukemia and their roles in monitoring minimal residual disease

ZHONG Jiaying¹, WU Yingying¹, LAO Mengxiao¹, ZHANG Xiaoyan¹, WANG Chunli², PAN Jianhua²

1. Guangzhou Medical University,Guangzhou 510182,Guangdong,China
2. Department of Hematology and Flow Cytometry,Guangzhou Kingmed Diagnostics,Guangzhou 510005,Guangdong,China

Received:2017-08-17 Online:2018-09-30 Published:2018-10-13

摘要/Abstract

摘要：

目的探讨CD123和CD66c在儿童急性B淋巴细胞白血病（B-ALL）中的表达及其在微小残留病（MRD）监测中的应用价值。方法采用多参数流式细胞术（MFC）检测141例初诊B-ALL患儿CD123和CD66c在骨髓中的表达情况。另选取25例急性髓系白血病（AML）患者作为对照组,经治疗症状完全缓解后采集其骨髓标本,所有标本均含比例不等的正常增生B系前体细胞。当初诊患儿抗原表达不同于对照组时,选取CD10/CD34/CD19/CD45做进一步MRD抗体组合检测。结果 CD123和CD66c在正常增生B系前体细胞和成熟B淋巴细胞中均不表达。在141例B-ALL患儿中,分别有88例（62.41%）CD123和70例（49.65%）CD66c表达阳性。分别有45例选择CD123和52例选择CD66c用于MRD监测,选择CD123和CD66c用于监测的病例有35例,选择CD123或CD66c用于监测的病例有62例,覆盖率为43.97%。CD123和CD66c在MRD监测中均具有良好的稳定性,无衰减或变弱。结论 CD123和CD66c均可用于儿童B-ALL MRD监测,但需联合其他筛选指标,以提高MRD监测的覆盖率。

关键词: CD123, CD66c, 急性B淋巴细胞白血病, 微小残留病

Abstract:

Objective To investigate the expressions of CD123 and CD66c in childhood B-cell acute lymphoblastic leukemia （B-ALL） and their roles in monitoring minimal residual disease （MRD）. Methods Multiparameter flow cytometry （MFC） was used to determine the expressions of CD123 and CD66c in bone marrow samples of 141 children with newly diagnosed B-ALL. A total of 25 children with acute myeloid leukemia （AML） with complete remission after chemotherapy were enrolled as control group,and their bone marrow samples had a proportion of normal B-progenitor cells. The antigens being different from those of control group were selected as MRD monitoring markers,and they were combined with CD10/CD34/CD19/CD45 antibodies for MRD monitoring. Results The expressions of CD123 and CD66c in normal B-progenitor cells and mature B-lymphocytes were negative. In the 141 cases of childhood B-ALL,there were 88 cases （62.41%） with the positive expression of CD123 and 70 cases （49.65%） with the positive expression of CD66c,respectively. The number of CD123 used for MRD monitoring was 45,and that of CD66c was 52. There were 35 cases with both CD123 and CD66c used for MRD monitoring,and there were 62 cases with CD123 or CD66c used for MRD monitoring,which the coverage rate was 43.97%. CD123 and CD66c showed good stabilities in MRD monitoring,with no decay or decline of antigen expression. Conclusions CD123 and CD66c can be used for MRD monitoring of childhood B-ALL,which should be combined with other markers so as to improve the coverage of MRD monitoring.

Key words: CD123, CD66c, B-cell acute lymphoblastic leukemia, Minimal residual disease

中图分类号:

R446.1

钟嘉颖, 吴英英, 劳梦晓, 张小艳, 王春丽, 潘建华. CD123和CD66c在儿童B-ALL中的表达及其在MRD监测中的应用[J]. 检验医学, 2018, 33(9): 807-810.

ZHONG Jiaying, WU Yingying, LAO Mengxiao, ZHANG Xiaoyan, WANG Chunli, PAN Jianhua. Expressions of CD123 and CD66c in childhood B-cell acute lymphoblastic leukemia and their roles in monitoring minimal residual disease[J]. Laboratory Medicine, 2018, 33(9): 807-810.

图/表 3

表1 CD123和CD66c在儿童B-ALL中的表达水平

免疫分型	例数	CD123（%）	CD66c （%）
Pro-B-ALL	6	1.77（0.32~64.15）	0.66（0.12~1.40）
Common-B-ALL	123	44.49（0.01~98.84）	29.58（0.05~99.56）
Pre-B-ALL	12	60.47（3.71~97.75）	12.35（0.45~96.93）

表2 CD123和CD66c在B-ALL患儿MRD监测中的应用 [例（%）]

指标	阳性	MRD监测
CD123	88（62.41）	45（31.91）
CD66c	70（49.65）	52（36.88）
CD123和CD66c	62（43.97）	35（24.82）
CD123或CD66c	96（68.09）	62（43.97）

图1 CD123在B-ALL患儿MRD监测中的应用注：（a）1例初诊患儿B-ALL肿瘤细胞CD123阳性表达;（b）诱导治疗结束第15天进行MRD检测,FS/SS设门,依次圈出R1门、R2门,采用CD19+CD34+和CD19+CD34-双设门,与初诊原始数据比较,双参数点图上白血病细胞出现的区域内仍有成团出现的细胞,即白血病残留细胞,这些残留细胞（R5和R6细胞数之和,再减去同型对照门内的细胞）占骨髓单个核细胞总数的比例即MRD水平,为2.38%;（c）维持治疗,MRD水平<0.01%

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CD123和CD66c在儿童B-ALL中的表达及其在MRD监测中的应用

Expressions of CD123 and CD66c in childhood B-cell acute lymphoblastic leukemia and their roles in monitoring minimal residual disease

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