摘要
目的探讨急性淋巴细胞性白血病（ALL）患儿中CD38的表达特点以及与临床预后的关系，以指导个体化治疗。方法79例儿童急性淋巴细胞性白血病（B系）初发者，入院后均应用流式细胞仪进行免疫分型，并同时进行微小残留病变（MRD）的筛选，当抗原表达符合CD38低表达时，进一步与其他3色抗体（CD10、CD19和CD34）一起进行共4色的抗体组合检测，作为筛选指标进行进一步的监测。根据CD38表达将ALL患儿分为CD38高表达组和CD38低表达组，对两组进行免疫分型特点、危险分层和生存时间的比较，统计分析使用SPSS16．0软件，P〈0．05为差异有统计学意义。结果初发急性淋巴细胞性白血病（B系）患儿共79例，CD38低表达组为50／79例（63．3％），CD38高表达组为29／79例（36．7％）；79例患儿中仅存在cD38／cD10／cD34／cD19一个筛选指标的4例，包含CD38／CD10／CD34／CD19且≥2个其他筛选指标（如TdT／CD10／CD34／CD19、CD66c／CD10／CD34／CD19和CD45／CD10／CD34／CD19等）的46例，无筛选指标的18例。危险分层中CD38低表达、CD38高表达两组分别为低危21／5例，中危14／15例，高危15／9例。CD38低表达组中early Pre-B33例，Pre—B12例，Mature-B5例，CD38高表达组中eadyPre-B21例，Pre-B5例，Mature-B3例；两组中CD38高表达组的高危分层明显大于CD38低表达组（F=6．24，P=0．044），并且生存时间明显小于CD38低表达组，差异有统计学意义（χ2=5．22，P=0．022）。结论CD38低表达时可作为急性淋巴细胞性白血病的MRD监测指标，CD38高表达组生存时间缩短，可能为ALL预后不良的独立危险因素。
Objective To investigate CD38 expression characteristic and the relation of clinic prognosis in children with acute lymphoblastic leukemia,in order to improve individual treatment. Methods Seventy-nine patients with childhood acute lymphoblastic leukemia（B-lineage） were enrolled into this study. Four-color fluorochrome labeled monoclonal antibodies were applyed to analyze the cell immunophenotypes and minimal residual disease screening. When CD38 low-expression was considered to be the effective screening marker and be used to continue monitoring. All patients were divided into CD38 low-expression groups and CD38 high-expression groups, to compared the immunophenotyping characteristic, risk stratification and survive rate of the two groups. All datas were assessed by means of SPSS16.0 and a P value of 0.05 or less was considered to indicate statistical significance. Results All of 79 newly diagnosed ALL-B, The group of CD38 low-expression were 50/79 （63.3 % ） while the other group were 29/79 （36.7 % ）. of all patients, 11 chilldren showed only a screening indicator-CD38/CD10/CD34/CD19, while 46 belonged to more than one markers （Such as TdT/CDlO/CD34/CD19, CD66c/CDlO/CD34/CD19 and CD45/CD10/CD34/ CD19） and 18 no markers. The stratification of CD38 low-expression and CD38 high-expression groups as follows ： 21/5 patients with low-risk, 14/15 with medium risk and 15/9 with high-risk. In the CD38 low-expression group, Early Pre-B 33, Pre-B 12, Mature-B 5, while in the CD38 high-expression group, Early Pre-B 21, Pre-B 5, Mature-B 3. This study showed that the high-risk stratification in the CD38 high-expression group was obviously higher than the CD38 low-expression group（ F= 6.24, P= 0.044）, but the survival time was signicantly shorter than CD38 low-expression group（ χ2= 5.22 ,P= O. 022）and the difference was statistically significant. Conclusion CD38 as a MRD monitoring indicator of most acute lymphoblastic leukemia when it low-expression, CD38 high-expression in newly diagnosis childhood acute lymphoblastic leukemia（B-lineage） may be an independent risk factor for predicting poor prognosis.
出处
《中华微生物学和免疫学杂志》
CAS
CSCD
北大核心
2012年第10期890-893,共4页
Chinese Journal of Microbiology and Immunology
