摘要
目的 观察CD19在儿童急性白血病 (AL)中的表达与分布 ,为白血病的诊断、鉴别以及导向治疗提供依据。方法 采用 2 7个荧光直标单克隆抗体 (简称单抗 )及CD45/SSC双参数设门多色流式细胞术对 2 10例儿童AL细胞进行免疫诊断和分型 ,并对CD19在各种类型AL细胞中的表达情况进行分析。结果 在 93例急性淋巴细胞性白血病 (ALL)病例中 ,CD19的阳性率 ( 99% ,92 / 93)明显高于B细胞系其他相关抗原的阳性率 ,如CD10 ( 88% ,82 / 93,P =0 0 0 3)、CD2 0 ( 2 5 % ,2 3/ 93,P= 0 0 0 1)和CD2 2 ( 6 0 % ,5 6 / 93,P =0 0 0 1) ;CD19在 9例含B系成分的杂合型白血病 (hybridacuteleukemia ,HAL)中全部表达 ,而在 2 4例T细胞系ALL和 5例T/My(髓 )HAL上均无表达 ;在 79例急性髓系白血病 (AML)中 ,仅 5例 ( 6 % )CD19阳性 ,明显低于它在B系ALL中的阳性率 ( 99% ,P =0 0 0 1)。结论 CD19对B系ALL细胞的特异性较好 ,敏感性高 ,在B细胞系各个分化阶段持续稳定表达 ,是诊断B系ALL较为可靠的表面标记 。
Objective To investigate the expression of CD19 on childhood acute leukemia (AL) and its significance, and to provide evidence for the diagnosis and differential diagnosis as well as monoclonal antibody targeting treatment of leukemia Methods There were 210 cases of childhood AL, of which 130 cases were male and 80 were female with a mean age of 9 years old Using a panel of 27 fluorochrome directly labeled monoclonal antibodies, 210 samples from the patients were analyzed with CD45/SSC double parameters and multi color flow cytometry to determine the expression of CD19 Results In the 93 cases of B lineage acute lymphoblastic leukemia (ALL), the positive rate (98.9%, 92/93) of CD19 was significantly higher than that of the other B cell related antigens, such as CD10 (88 2%, 82/93, P = 0 003), CD20(24.7%, 23/93, P = 0 001)and CD22 (60 2%, 56/93, P = 0 001) CD19 was expressed on all 8 cases of B/myeloid (My) hybrid acute leukemia (HAL) and 1 case of B/T HAL, but was not expressed on all 24 cases of T lineage leukemia and 5 cases of T/My HAL In the 79 cases of acute myeloid leukemia (AML), only 5 (6 3%) cases expressed CD19 The positive rate (6 3%) of CD19 on AML was significantly lower than that on B lineage ALL (98 9%, P = 0 001) The percentage of CD19 positive cells in B/My HAL (41 6%~88 7% with a mean of 73 8%) was significant higher than that in CD19 + AML (21 4%~50 4% with a mean of 24 2%; Run Sum test, P = 0 0084) Of the 210 cases, 102 were B lineage related AL including B lineage ALL, B/My HAL and B/T HAL In B lineage related AL, the sensitivity and the specificity of CD19 was 99 0% (101/102) and 95 4%(13/108) while the positive predictive and the negative predictive values to B lineage were 95 3%(101/106) and 99 0%(103/104), respectively Using CD19 + as a single reagent to diagnose B lineage, the false positive rate was 4 6% (5/108) and the false negative rate was 1 0% (1/102) with a general diagnosis index (GDI) of 94 4% [GDI = 1 (false positive rate + false negative rate)] Conclusion CD19 is continuously and stably expressed on all stages of B lineage differentiation It is a reliable cell membrane marker for diagnosing B lineage ALL and an ideal target for antibody targeting treatment of leukemia as well; the expression degree of CD19 can be used to distinguish B/My HAL from CD19+ AML; CD19 didn′t express on normal myeloid cells but did on some AML cells Therefore it can be used to detect the minimal residual disease
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2004年第3期188-191,共4页
Chinese Journal of Pediatrics
基金
浙江省自然科学基金资助 (3 0 15 70 )