急性白血病细胞CD19和CD20表达比较(英文)

Comparison between CD19 and CD20 Expression Patterns on Acute Leukemic Cells

本研究目的是观察CD19和CD20在急性白血病(AL)细胞中的表达与分布,为急性B系白血病靶向分子 的选择提供合理依据。采用27个荧光直标单克隆抗体及CD45/SSC双参数设门多色流式细胞术对321例AL细胞 进行免疫诊断和分型,并对CD19和CD20在各种类型AL细胞中的表达情况进行分析。结果表明,在116例B系 ALL病例中,CD19持续稳定表达,其阳性率(115/116,99.1%)明显高于CD20(33/116,28.4%,P=0.001);在 17例含B系成分的混合型白血病(acutemixedlineageleukemia,AMLL)细胞中,前者的阳性率也明显高于CD20(P <0.01),而在29例T细胞系ALL和7例T/MyHAL细胞中,两者均无表达;在152例急性髓系白血病(AML)细胞 中,CD19和CD20阳性率均很低,分别为7.2%和2.0%;CD19和CD20在B ALL及B/MyAMLL组中的荧光强度差 别有显著性(t=20.68,P<0.001);CD19和CD20的特异性分别为92.3%(132/143)和92.7%(38/41),敏感 性分别为99.2%(132/133)和28.6%(38/133),前者敏感性明显高于后者(χ2=144.018,P=0.001)。结论: CD19在B细胞系细胞的各分化阶段上持续稳定表达,反应谱比CD20宽,特异性及敏感性均高,尤其是其敏感性显 著高于后者。这提示CD19抗原分子可能成为治疗B系ALL的最佳靶点。

In order to provide the evidences for CD19 as a better antibody targeting molecule for B lineage acute leukemias than CD20 through the multi-parameter flow-cytometry analysis of leukemia cells, the samples from 321 patients with acute leukemia （AL） were immunophenotyped by multi-color flow cytometry and CD45/SSC gating strategy followed by the analysis of CD19 and CD20 expression. The results showed that the positive rate of CD19 （115/116, 99.1% ） in 116 cases with B lineage acute lymphoblastic leukemia （B lineage ALL） was significantly higher than that of CD20 （33/116, 28.4% ）（P〈0.01 ）; in 17 patients with B lineage/Myeloid （B/My） acute mixed lineage leukemia （ AMLL）, the former positive rate （ 17/17, 100% ） was also higher than the latter （5/17, 29.4% ） （P 〈 0.01 ）. Both of the two antigens were negative in 29 patients with acute T lymphoblastic leukemia and 7 patients with T/My AMLL.The positive rates of CD19 and CD20 in 152 patients with acute myeloid leukemia （AML） were 7.2% and 2.0%, respectively. The difference of the fluorescence intensity between the two antigens on the cells from each patient with B lineage ALL or B/My AMLL was statistically significant （t = 20.68, P 〈0.001 ）. The specificity of CD19 and CD20 in B lymphocytic lineage was 92.3% （132/143） and 92.7% （38/41）, respectively, while the sensitivity was 99.2%（ 132/133 ） and 28.6% （38/133）, respectively, the former sensitivity was significantly higher than the latter （ X^2 = 144.018, P =0.001 ）. It is concluded that CD19 continuously and steadily express on almost all subtypes of B lineage leukemic cells with homogeneous pattern while only a small number of leukemias express CD20. Both the specificity and sensitivity of CD19 were very high with a much broader reaction pattern than that of CD20 on this group of diseases. These indicate that CD19 may be a better antibody targeting molecule than CD20 for patients with B-lineage acute leukemia.