慢性淋巴细胞白血病血清可溶性CD23及血小板生成素研究

Serum levels of soluble CD23 and thrombopoietin in chronic lymphocytic leukemia

目的探讨慢性淋巴细胞门血病（CLL）患者血清可溶性CD23（sCD23）及血小板生成素（TPO）水平及与其他预后指标的相关性。方法采用酶联免疫吸附试验检测25例CLL患者外周血标本中sCD23及TPO的水平；流式细胞术检测ZAP-70蛋白及CD38的表达。结果CLL患者TPO水平为67．22～1881．77ng／L，明显高于正常对照组70．29～147．98ng／L（P=0．003）；CLL患者血清sCD23水平为129．80～405．31U／ml，也明显高于正常对照组0．65～32．99U／ml（P=0．000）。血清TPO水平与Binet分期、CD38具有显著相关性。BinetA期患者TPO水平为121．92～163．83ng／L，低于BinetB和C期患者140．57～457．48ng／L（P=0．014）；CD38高表达组TPO水平113．23～199．10ng／L，高于CD％低表达组141．34～454．92ng／L（P=0．033）。而TPO与ZAP-70表达及sCD23与CD38、ZAP-70表达尤明显相关忡。另外，血清sCD23及TPO与患者性别、年龄、外周血淋巴细胞计数和乳酸脱氢酶均无相关性。结论血清TPO水平对CLL预后判断可能具有一定的价值。

Objective To investigate the serum levels of soluble CD23 （sCD23） and thrombopoietin （TPO） in chronic lymphocytic leukemia （CLL） and their correlation with other prognostic factors. Methods The serum levels of sCD2z and TPO of 25 CLL patients were detected with enzyme linked immunosorbent assay. Flow cytometry was employed to determine the expression of CD38 and ZAP-70 protein. Results TPO level in CLL patients was significantly higher than that in normal controls 67.22 - 1881.77 ng/L and 70. 29 - 147.98 ng/L respectively, P =0. 003. sCD23 level in CLL patients was significantly higher than that in normal controls 129. 80 -405.31 U/ml and 0. 65 -32. 99 U/ml respectively, P =0. 000. TPO level was significantly correlated with Binet stage and CD3s expression. Patients in stage B and C had higher level of TPO than those in stage A 140. 57 - 457.48 ng/L and 121.92 - 163.83 ng/L respectively, P =0. 014, while TPO level was higher in patients with higher CD38 expression than in patients lower CD3s expression 113.23 - 199. 10 ng/l, and 141.34 - 454. 92 ng/L respectively, P = 0. 033. No significant correlation of sCD23 and TPO levels with ZAP-70 protein, sex, age, peripheral lymphocyte count and lactate dehydrogenase were observed. Conclusion Serum TPO level might be a prognostic factor in CLL.