老年急性髓系白血病患者化疗后微小残留监测和CD99表达对预后的影响研究

Study on effects of minimal residual monitoring and CD99 expression on prognosis of elderly patients with acute myeloid leuke-mia after chemotherapy

中文关键词: 老年  急性髓系白血病  微小残留病  CD99  预后

英文关键词: elderly  acute myeloid leukemia  minimal residual disease  CD99  prognosis

中文摘要:

      目的 分析老年急性髓系白血病(AML)患者化疗后微小残留病(MRD)阳性数和CD99表达对患者预后的影响,以期为临床患者的诊疗提供新思路.方法 回顾性选取2020年1月 2024年1月在重庆市黔江中心医院和山东省日照市人民医院接受治疗的100例老年AML患者.评估患者的预后状况,将出现死亡患者作为预后不良组(n=41),未死亡患者作为预后良好组(n=59).记录并比较预后良好组和预后不良组患者FCM-MRD阳性数、CD99表达量,分析FCM-MRD阳性数、CD99表达量与老年AML患者临床特征、预后的关系.结果 治疗后,预后良好组患者FCM-MRD阳性数、CD99表达量低于同组治疗前和预后不良组(P＜0.05).FCM-MRD阳性数、CD99表达和老年AML患者细胞遗传学、骨髓原始祖细胞、血清WBC水平、脾肿大及FAB分型相关(P＜0.05).Kaplan-Meier生存曲线表明,CD99低表达组患者OS高于CD99高表达组(P＜0.05),FCM-MRD阴性组患者OS高于FCM-MRD阳性组(P＜0.05).ROC曲线显示,FCM-MRD联合CD99检测的AUC高于FCM-MRD、CD99单一检测,具有较高的特异度与敏感度.结论 FCM-MRD 联合CD99可能是评估老年AML患者预后的重要手段,对患者病情发展、预后改善具有一定的评估作用.

英文摘要:

      Objective To analyze the effects of minimal residual disease(MRD)positivity and CD99 expression on the prognosis of elderly patients with acute myeloid leukemia(AML)after chemotherapy,and provide a new idea for clinical diag-nosis and treatment.Methods A total of 100 elderly patients with AML from Central Hospital of Qianjiang City and People's Hospital of Rizhao City from January 2020 to January 2024 were retrospectively selected,and their prognosis was evaluated.The patients who died were classified as the poor prognosis group(n=41),and those who did not die were classified as the good prognosis group(n=59).The positive number of FCM-MRD and CD99 expression levels were recorded and compared between the two groups.The relationship between the positive number of FCM-MRD,the expression level of CD99 and the clinical characteristics and prognosis of elderly AML patients were analyzed.Results After treatment,the positive number of FCM-MRD and the expression level of CD99 in the good prognosis group were lower than those in the same group before treat-ment and in the poor prognosis group(P＜0.05).The positive rate of FMM-MRD and the expression level of CD99 were sig-nificantly correlated with cytogenetics,bone marrow progenitor cells,serum white blood cell(WBC)level,splenomegaly and FAB classification in elderly AML patients(P＜0.05).Kaplan-Meier survival curve showed that patients with low expression of CD99 had longer overall survival(OS)than those with high expression of CD99,and the FMM-MRD negative group had longer OS than the FMM-MRD positive group(P＜0.05).The ROC curve analysis showed that the AUC of FCM-MRD com-bined with CD99 detection was larger than that of FCM-MRD or CD99 detection alone,with higher specificity and sensitivity.Conclusion The combination of FCM-MRD and CD99 may be an important tool for evaluating the prognosis of elderly AML patients.It has a certain evaluation effect on the disease development and prognosis improvement of patients.