B细胞激活因子在慢性淋巴细胞白血病中的表达及临床意义

Expression and significance of BAFF in chronic lymphocytic leukemia

目的研究B细胞激活因子(B cell activating factor,BAFF)在慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)病人中的表达以及与CLL预后指标的相关性,探讨其在CLL预后中的意义。方法采用实时定量逆转录聚合酶链反应(PCR)技术检测CLL病人外周血单个核细胞及正常人外周血B细胞中BAFF基因mRNA表达水平,运用循环阈值(cycle threshold,Ct)比较法进行相对定量分析。结果 BAFF在101例CLL病人中的表达水平明显高于正常对照组(P<0.0001);Binet分期早期(A期)组BAFF mRNA表达水平明显高于Binet分期晚期(B/C期)组(P=0.048),ZAP-70表达阳性组BAFF mRNA表达水平明显高于ZAP-70表达阴性组(P=0.041)。中位随访时间为27.9月(1~72月),69例病人诊断后接受化疗,BAFF低表达组病人获得较短的无治疗生存时间(treatment-free survival,TFS),提示BAFF mRNA低表达是TFS的不良预后因素(P=0.017)。结论CLL病人存在BAFF基因的高表达,BAFF基因表达水平与Binet分期、ZAP-70阳性表达明显相关,对预后有一定影响。

Objective To investigate the expression of B cell activating factor（ BAFF） in chronic lymphocytic leukemia（ CLL）,and to explore the association with clinical and laboratory features and the prognosis. Methods The level of BAFF mRNA was quantified using qRT-PCR with SYBR Green by ABI 7300 in peripheral blood mononuclear cells（ PBMC） from CLL patients and purified CD19＋B cells from healthy donors. The relative expression level of mRNA was analyzed by cycle threshold method.Results The expression level of BAFF was higher in 101 CLL patients than that in healthy donors（ P〈0. 0001）. BAFF expression was significantly higher in early Binet stage than that in advanced stage（ P =0. 048）,also higher in ZAP-70 positive patients than that in ZAP-70 negative patients（ P = 0. 041）.Sixty-nine patients received therapy after initial diagnosis,with a median follow-up of 27. 9 months（ range,1-72 months）. Survival analysis showed that the patients with low BAFF expression had shorter TFS time than those with high BAFF expression（ P = 0. 017）. Conclusions The expression level of BAFF gene increases in CLL patients. BAFF expression is correlated with Binetstage and ZAP-70 expression,indicating a significant prognosis in CLL.