慢性B细胞淋巴细胞白血病的免疫表型研究

Research on Immunophenotype in Chronic B Lymphocytic Leukemia

目的探讨免疫表型在慢性B细胞淋巴细胞白血病(B-CLL)诊断及预后评价中的应用价值。方法应用流式细胞仪,采用系列相关单克隆抗体和三色流式细胞术对37例慢性B细胞淋巴细胞白血病患者进行免疫表型分析。结果 37例B-CLL患者中大部分表达CD5、CD19、CD20、人白细胞DR抗原(HLA-DR),有部分表达CD22、cyCD79a、CD38、zeta链相关蛋白70(ZAP-70),极少表达CD7、CD13,不表达CD3、CD14、CD34。B-CLL患者ZAP-70表达的阳性率为13.5%,其中Binet A期患者有3.8%(1/26)表达ZAP-70,Binet B+C期患者有36.4%(4/11)表达ZAP-70,ZAP-70在Binet A期和Binet B+C期的表达存在显著差异(P<0.05)。结论对B-CLL患者进行免疫表型分析,对于诊断及预后评价有重要意义。ZAP-70可作为B-CLL有效的预后指标。

Objective To investigate the application value of immunophenotype in diagnosis of chronic B lymphocytic leukemia（B-CLL）and prognostic evaluation.Methods Immunophenotyping was performed in 37 patients with B-CLL by three-color multiparameter flow cytometry analysis using a panel of monoclonal antibodies.Results In 37 cases,most patients expressed CD5,CD19,CD20 and human leukocyte antigen DR（HLA-DR）,some patients expressed CD22,cyCD79a,CD38 and zeta-associated protein-70（ZAP-70）,very few patients expressed CD7 and CD13,none of the patients expressed CD3,CD14 and CD34.The positive rate of ZAP-70 expression in B-CLL patients was 13.5%,ZAP-70 expression in Binet A stage was 3.8%（1/26）,and ZAP-70 expression in Binet B＋C stage was 36.4%（4/11）.The expression of ZAP-70 had significant difference between Binet A and Binet B＋C（P0.05）.Conclusion The immunophenotyping technique is very effective in diagnosis and evaluation of prognosis of B-CLL,ZAP-70 can be a valid prognostic index of this disease.