CD11c在慢性淋巴细胞白血病诊断中的意义

Diagnostic Value of CD11c Antigen in Patients with Chronic Lymphocytic Leukemia

目的:探讨CD11c抗原在慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)中的表达及在临床诊断中的价值,以及CD11c抗原表达与患者的遗传学异常及预后参数的相关性。方法:采用多参数流式细胞术(flow cytometry,FCM)检测200例CLL患者、49例套细胞淋巴瘤(mantle cell lymphoma,MCL)患者CD11c的表达率和平均荧光强度(mean fluorescence intensity,MFI);并比较CLL患者CD11c的表达与预后参数ZAP-70和CD38表达的关系;同时采用荧光原位杂交(fluorescence in situ hybridization,FISH)技术检测CLL患者的P53缺失、13q14缺失、ATM缺失、6q23缺失、+12以及IGH重排,比较CD11c^+CLL患者与CD11c^-CLL患者遗传学特点。结果:CLL患者中CD11c阳性率为49.5%(99/200),MFI中位值为2.06(1.00~7.34);而MCL患者中CD11c阳性率为6.12%(3/49),MFI中位值为2.00(1.97~2.54)。CD11c在CLL中的表达率明显高于MCL,(x^2=30.62,P<0.05)。CD11c^+CLL患者的ZAP-70和CD38阳性率均明显高于CD11c^-CLL患者(x^2=15.472,P<0.05;x^2=11.556,P<0.05),差异有统计学意义。而CLL患者的CD11c表达率与P53缺失、13q14缺失、ATM缺失、6q23缺失、+12、IGH重排的结果均无统计学差异。结论:CD11c对于辅助诊断CLL有重要价值,尤其有助于CLL和MCL的诊断和鉴别诊断。

Objective:To explore the expression of CD11c antigen in patients with chronic lymphocytic leukemia(CLL),and its clinical diagnostic value,as well as the correlation of CD11c with genetic abnormalities.Methods:200 cases of CLL,49 cases of MCL were detected for CD11c expression rate and mean fluorescence intensity(MFI)by Multi parameter flow cytometry(FCM).And the relationship between CD11c expression and prognostic markers(ZAP-70 and CD38)expression in 200 CLL patients were compared.At the same time,the fluorescence in situ hybridization(FISH)was used to detecte P53 deletion,13q14 deletion,ATM deletion,6q23deletion,+12 and IGH rearrangement.Then the genetic abnormalities were compared between CD11c^-and CD11c^+CLL patients.Results:The CD11c positive rate in CLL patients was 49.5%(99/200),MFI median2.06(1.00 to7.34).While the CD11c positive rate in MCL patients was 6.12%(3/49).MFI median2.00(1.97 to 2.54).The positive rate of CD11c expression were significantly higher in CLL patients than in MCL patients(x^2=30.62,P<0.05).The positive rate of ZAP-70 and CD38 were significantly higher in CD11c^+CLL patients than CD11c^-CLL patients(x^2=15.472,P<0.05;x^2=11.556,P<0.05).The results of P53deletion,13q14 deletion,ATM deletion,6q23 deletion,+12 and IGH rearrangement were all not significantly different between CD11c^-and CD11c^+CLL patients.Conclusion:CD11c has significant value for assistan diagnosis of CLL,especially for the differential diagnosis between CLL and MCL.