Detection Of Immunophenotype In Acute Myeloid Leukemia By Multi-parameter Flow Cytometry And Its Clinical Application

BackgroundAcute myeloid leukemia?AML?is a common type of acute leukemia?AL?,which is a malignant tumor of the hematopoietic system.It is more common in adults.AML is characterized by rapid onset,varying degrees of fever,hemorrhage,anemia,bone pain and enlargement of lymph nodes,liver and spleen,which may endanger the life of the patient.The myeloid leukemia cells of patients with this type of disease have abnormal clonal proliferation,differentiation with maturation disorder,and decreased apoptosis.Myeloid leukemia cells have strong heterogeneity in cell morphology,treatment response and prognosis^[1],FAB morphological examination It is the basis of the diagnosis of AML,but the human subjectivity is relatively large,which can no longer meet the needs of clinical diagnosis and treatment.At present,the diagnosis of AML is now mostly combined with morphology,immunology,cytogenetics,and molecular biology?MICM?to diagnose AML.With the rapid development of flow cytometry?FCM?,FCM has become an indispensable method for AML diagnosis due to its high throughput,objectiveness and low sample requirements.This technology can quickly and accurately detect AML cells The series,antigen distribution,and differentiation stage of the virus are of great significance for guiding clinical diagnosis,stratified treatment and prognostic judgment^[2].At present,there are many studies on the expression analysis of AML cell differentiation antigens,but there are few literature reports and lack of systematic research on the relationship between the prognostic efficacy of leukemia cell differentiation antigens,especially the expression of non-myeloid differentiation antigens and the complete remission?CR?rate.ObjectiveTo study and analyze the immunophenotype of AML and the expression characteristics of non-myeloid differentiation antigens,and explore the relationship between the expression of AML cell differentiation antigens and prognostic efficacy.MethodsAccording to the diagnosis requirements,the antibody combination plan wasdesigned,using BD FACSCalibur flow cytometer,analyzing by Cellquest software,using CD45 combined with side-scattered light SSC to set up the gating,and 109 cases of AML were tested for immunophenotype.SPSS18.0 statistical analysis software?²test was used to analyze and compare the CR rates of patients with positive and negative AML related antigen expression;compare the CD56-positive and CD56-negative groups of 15 AML-M2b patients with positive AML1-ETO expression in 1 course of treatment remission rate and recurrence rate within 1 year.Results1.Immunophenotype showed that the positive rates of myeloid differentiation antigens CD13,CD117,CD33,MPO and CD15 in AML cells decreased successively,with no statistically significant difference in the positive rates of CD117,CD13,CD33and MPO?P>0.05?,all of which were higher than the positive rates of CD15?all P<0.05?.2.There was no significant difference in the positive rates of AML cell non-Lineageantigen CD34,CD38,HLA-DR and CD123?P>0.05?.3.The positive rates of AML cell non-myeloid differentiation antigens CD9,CD200,CD56 and CD7 decreased successively,all of which were higher than CD25,CD19,CD2,CD10,CD4,Cy CD79a and Cy CD3?all P<0.05?,and no expression of Cy CD3was found.The species and positive rates of M₅non-myeloid differentiation antigens in AML subtypes were more frequent,and the M3 CD9 positive expression was high-frequency and high-intensity.4.After 109 AML patients received chemotherapy,the prognosis reached complete remission?complete remission,CR?in 71 patients with a CR rate of 65.1%.Among the109 AML patients,the CR rates of AML patients with CD7,CD34,CD56 and CD25positive expression were 44.1%?15/34?,45.8%?44/96?,43.8%?21/48?,37.5%?6/16?,which were lower than those of the negative patients with CR rates of 70.7%?53/75?,76.9%?10/13?,75.4%?46/61?,62.4%?60/93?,and the differences were statistically significant??²=7.027,P=0.008;?²=4.427,P=0.035;?²=11.368,P=0.001;?²=4.171,P=0.041?,and the CR rates of AML patients with MPO and CD19 positive expression were 70.9%?66/93?,61.5%?8/13?,which were higher than those of the negative patients with CR rates of 31.3%?5/16?,31.3%?30/96?,and the differences were statistically significant??²=9.483,P=0.002;?²=4.625,P=0.032?.5.Among the 15 AML-M2b patients with AML1-ETO positive expression,1 course CR rate of CD56 positive group was lower than that of CD56 negative group,and the relapse rate within 1year of CD56 positive group was higher than that of CD56negative group,and thedifferences were statistically significant??²=5.000,P=0.025;?²=5.000,P=0.025?.ConclusionImmunotype and non-myeloid differentiation antigens expression analysis is of great clinical significance for the diagnosis and prognosis of AML,and is one of the main bases for the diagnosis and treatment of AML.