| Background and objectiveAcute leukemia is one of malignant clonal diseases along with a wide range of extramedullary infiltration, such as violations of the liver, spleen, marrow, lymph nodes, bone, skin, central nervous system and other organs, in which infiltration of lymphoid organs such as lymph nodes and spleen is an influential factor of prognoses, leading to a lower relief, high recurrence and poor prognose. In recent years, the key role of chemokine receptors in tumor cell metastasis has been more and more valued, and the chemokine receptor-7(CC-chemokine receptor 7 CCR7),one of homing receptors of immune cells, has be confirmed expressing in a number of solid tumors and hematological malignancies associated with tumor cell invasion and metastasis. In this study, flow cytometry was used to detect CCR7 expression of leukemia cells in 71 cases of adult acute leukemia patients(aged ?12 years), and to explore the relationship between CCR7 expression and clinical characteristics, such as age, gender, diagnosis, classification, peripheral WBC, the proportion of neoplastic cells number in bone marrow, CD56 expression, molecular biology and cytogenetic risk stratification, and so on in adult acute leukemia. MethodsWe detected the expression of CCR7 on leukemia cells of 71 patients with adult acute leukemia who received final diagnosis by the Department of Hematology in the First Affiliated Hospital of Zhengzhou University between September 2014 and August 2015, by means of flow cytometry(FCM). The 71 patients includes 42 males and 29 females, age 14 to 89 years, with a median age of 42.5 years. There were 52 cases of acute myeloid leukemia including 2 with AML-M1, 22 with AML-M2, 7 with AMl-M3, 8 with AML-M4 and 13 with AML-M5. The remaining 19 patients are acute lymphocyte leukemia comprised of 16 B-ALL and 3 T-ALL patients.,collecting the clinical information and concluding relationships between them at the same time. Results1) CCR7 was expressed in human acute leukemia, while the positive rate in ALL was 36.8%(7/19),which was higher than that in AML with 9.6%(5/52), respectively. there were 5 CCR7+ cases of acute myeloid leukemia comprised of 1 with AML-M1, 1 with AML-M2, 2 with AMl-M3, 0 with AML-M4 and 1 with AML-M5.2) There was no significant relationship between the expressions of CCR7 and clinical characteristics, including the patients' age, gender, number peripheral WBC, the proportion of neoplastic cells number in bone marrow and CD56 expression.3) In AML, there is no correlation between CCR7 expression and molecular biology gene mutations including NPM1, C-kit, and FLT3. In ALL, there is no correlation between CCR7 expression and high risk cytogenetics including(t(9; 22) / BCR-ABL, t(4; 11) / MLL-AF4.4) In AML, there was no significant difference(P>0.05) of extramedullary infiltration positive rate between CCR7 positive group and CCR7 negative group. In ALL, extramedullary infiltration positive rate in CCR7 positive group was 100%(7/7), which was higher than that in CCR7 negative group with 41.7%(5/12), respectively(P <0.05). the CCR7 mean fluorescence intensity(MFI) in ALL with extramedullary infiltration group was high than that in ALL without extramedullary infiltration group(50.00 ± 10.42 vs 18.14 ± 1.39), the difference was statistically significant(P <0.05). ConclusionCCR7 was expressed in human adult acute leukemia, which positive rate in ALL was higher than that in AML. Neither AML nor ALL, the CCR7 positive rate was associated with clinical characteristics including the patients' age, gender, number peripheral WBC, the proportion of neoplastic cells number in bone marrow and CD56 expression, molecular biology gene mutations and high risk cytogenetics. However, in ALL, CCR7 expression was related to extramedullary infiltration closely. |
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