CD11c在慢性淋巴细胞白血病诊断中的意义

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,P0.05)。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,P0.05;x~2=11.556,P0.05),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。

Diagnostic Value of CD11c Antigen in Patients with Chronic Lymphocytic Leukemia

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, 6q23 deletion,+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 median 2.06(1.00 to7.34).While the CD11c positive rate in MCL patients was 6.12%(3/49).MFI median 2.00(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 P53 deletion, 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 assistant diagnosis of CLL,especially for the differential diagnosis between CLL and MCL.