CD38 ZAP-70在B慢性淋巴细胞白血病中表达及其临床意义的研究

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目的:检测CD38及zeta链相关蛋白-70(zeta-associated protein-70,ZAP-70)在B慢性淋巴细胞白血病(B-CLL)中的表达,探讨其与临床的相关性。方法:采用流式细胞仪检测51例B慢性淋巴细胞白血病(B-CLL)患者骨髓或外周血白血病细胞CD38和ZAP-70的表达,结合其与患者临床分期、病情进展、化疗疗效进行分析。结果:1)44例患者中10例(22.73%)CD38和ZAP-70同时表达阳性,22例(50%)CD38和ZAP-70同时表达阴性。2)31例CD38患者中,初诊时处于Binet B+C期者9例(29.03%);11例CD38+患者中,初诊时处于Binet B+C期者7例(63.64%)。CD38阳性、阴性表达在Binet分期上无显著差异(P>0.05)。27例ZAP-70-患者中,初诊时处于Binet B+C期者6例(占22.22%);16例ZAP-7+患者中,初诊时处于Binet B+C期者10例(62.5%)。ZAP-70阳性、阴性表达在Binet分期上有显著差异(P 0.05). Among 27 ZAP-70 patients, 6 (22.22%) were in Binet B + C stage at initial diagnosis and 10 (62.5%) in Binet B + C stage were diagnosed in 16 patients with ZAP-7 + . The positive and negative expressions of ZAP-70 were significantly different in Binet stage (P <0.05). 3) 23 patients were treated with fludarabine alone or in combination with CTX. Of the 16 CD38 patients, 11 (68.75%) were chemotherapy-effective (CR + PR); among 7 CD38 + Example (14.29%). In 11 cases of ZAP-70-expressing patients, 9 cases (81.82%) were effective in chemotherapy and 1 case (11.11%) of the 9 cases of ZAP-70 + expression were effective in chemotherapy. The positive and negative expressions of CD38 and ZAP-70 were significantly different from those of chemotherapy (P <0.05). Conclusion: 1) CD38 expression in B-CLL patients is related to the expression of ZAP-70. 2) The positive and negative expression of ZAP-70 in B-CLL patients is related to the Binet staging. The positive expression of ZAP-70 patients progressed more rapidly than negative expression. 3) The positive expression of CD38 and ZAP-70 in patients with B-CLL were less effective and less prognostic than those with negative expression. Using flow cytometry to detect the expression of ZAP-70 in combination with CD38 can be used as a reference index for the clinical classification and prognosis of chronic lymphocytic leukemia.
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