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目的:探讨慢性淋巴细胞白血病(CLL)患者免疫表型特点及其与临床分期的关系。方法:采用流式细胞术对35例CLL患者外周血或骨髓标本进行淋巴细胞常规表面抗原、CD38及ZAP-70表达等监测,了解免疫表型、CD38及ZAP-70表达在Rai分期的分布关系。结果:①35例CLL患者,男女比例为2.9:1;中位年龄67(37~80)岁,按修改后的Rai分期标准分为低危(0期)3例,中危(I期,II期)12例,高危(III期和IV期)20例。②35例患者中CD5,CD19,CD20及CD22阳性率分别为74.3%、100%、97.1%及97.1%。HLA-DR和CD38的阳性率为100%和42.9%;ZETA相关蛋白(ZAP-70)在CLL患者表达率为17.1%。③CD38在病程后期(RaiIII期和IV期)表达高于病程早期(Rai 0期、I期和II期),其差异性有明显的统计学差异(P<0.05),而其余表面抗原以及ZAP-70的阳性率与Rai分期均没有显著的统计学差异(P>0.05)。结论:CD38阳性患者在病程后期(RaiIII期和IV期)表达高于病程早期(Rai 0期、I期和II期),提示根据临床分期可初步对CD38的表达进行预测。
Objective: To investigate the immunophenotypic characteristics of patients with chronic lymphocytic leukemia (CLL) and its relationship with clinical stage. Methods: Flow cytometry was used to detect the expression of lymphocyte antigen, CD38 and ZAP-70 in peripheral blood or bone marrow of 35 patients with CLL. The distribution of immunophenotype, CD38 and ZAP-70 expression in Rai stage . Results: ①The ratio of male to female was 2.9: 1 in 35 patients with CLL. The median age was 67 (37-80) years. According to the modified Rai criteria, 3 cases were classified as low risk (stage 0) ) In 12 cases, high risk (III and IV) in 20 cases. ② The positive rates of CD5, CD19, CD20 and CD22 in the 35 patients were 74.3%, 100%, 97.1% and 97.1% respectively. The positive rates of HLA-DR and CD38 were 100% and 42.9%, respectively. The expression rate of ZETA-related protein (ZAP-70) in CLL patients was 17.1%. (3) The expression of CD38 in the late stage of disease (RaiIII and IV) was higher than that in early stage (Rai 0, I and II), the difference was statistically significant (P <0.05), while the rest of the surface antigen and ZAP- 70 positive rate and Rai staging were not significantly different (P> 0.05). Conclusions: The expression of CD38 in CD38-positive patients is higher than that in early stage of RaiIII and IV (stage Rai 0, stage I and stage II), suggesting that the expression of CD38 may be preliminarily predicted according to clinical stage.