成人急性B淋巴细胞白血病CD20表达及临床意义
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摘要
目的探析CD20表达在成人急性B淋巴细胞白血病中的应用价值。方法选取2013年1月～2018年1月在我院血液科明确诊断和治疗的92例成人急性B淋巴细胞白血病,均接受骨髓细胞形态学、白血病相关免疫表型、细胞遗传学及分子生物学检测,对检测结果进行回顾性分析。结果 CD20阳性组在年龄、性别、初诊白细胞数与CD20阴性组比较,差异无统计学意义(P> 0.05);92例患者中有85例患者完成了诱导治疗,治疗完成率为92.4%;CD20阳性组和CD20阴性组的CRI率比较无显著差异,CD20阳性组的bcrabl融合基因表达阳性率低于CD20阴性组(13.3%vs 25.9%),但两组比较差异无统计学意义(P> 0.05)。CD20阳性组和CD20阴性组5年总体生存率(OS)分别为27.5%和58.3%,CD20阳性组5年总生存率较低,但两组差异无统计学意义。结论 CD20阳性急性B淋巴细胞白血病患者与CD20阴性急性B淋巴细胞白血病患者在临床特征、治疗效果和预后方面比较差异无统计学意义(P> 0.05),CD20尚并不能作为急性淋巴细胞白血病的独立的预后因素。
Objective To explore the application value of CD20 expression in adults with acute B lymphocytic leukemia. Methods Ninety-two adults with acute B-lymphocytic leukemia who were clearly diagnosed and treated in the department of hematology of our hospital from January 2013 to January 2018 were selected. They were all given tested of bone marrow cell morphology, leukemia-related immunophenotyping, cytogenetics and molecular biology and the test results were retrospectively analyzed. Results There was no statistically significant difference in age, gender and the number of newly diagnosed leukocyte count between the CD20 positive group and the CD20 negative group(P> 0.05). 85 of the 92 patients completed induction therapy, with a completion rate of 92.4%. There was no significant difference in CRI rate between CD20 positive group and CD20 negative group. The positive rate of expression of bcrabl fusion gene in the CD20 positive group was lower than that in the CD20 negative group(13.3% vs 25.9%), but there was no statistically significant difference between the two groups(P>0.05). The 5-year overall survival rate(OS) of CD20 positive group and CD20 negative group was 27.5% and 58.3%, respectively. The 5-year overall survival rate was lower in the CD20 positive group, but there was no statistical difference between the two groups(P > 0.05). Conclusion There is no significant difference in clinical features, therapeutic effect and prognosis between patients with CD20 positive acute B lymphocytic leukemia and patients with CD20 negative acute B lymphocytic leukemia. CD20 is not an independent prognostic factor for acute lymphoblastic leukemia.
Objective To explore the application value of CD20 expression in adults with acute B lymphocytic leukemia. Methods Ninety-two adults with acute B-lymphocytic leukemia who were clearly diagnosed and treated in the department of hematology of our hospital from January 2013 to January 2018 were selected. They were all given tested of bone marrow cell morphology, leukemia-related immunophenotyping, cytogenetics and molecular biology and the test results were retrospectively analyzed. Results There was no statistically significant difference in age, gender and the number of newly diagnosed leukocyte count between the CD20 positive group and the CD20 negative group(P> 0.05). 85 of the 92 patients completed induction therapy, with a completion rate of 92.4%. There was no significant difference in CRI rate between CD20 positive group and CD20 negative group. The positive rate of expression of bcrabl fusion gene in the CD20 positive group was lower than that in the CD20 negative group(13.3% vs 25.9%), but there was no statistically significant difference between the two groups(P>0.05). The 5-year overall survival rate(OS) of CD20 positive group and CD20 negative group was 27.5% and 58.3%, respectively. The 5-year overall survival rate was lower in the CD20 positive group, but there was no statistical difference between the two groups(P > 0.05). Conclusion There is no significant difference in clinical features, therapeutic effect and prognosis between patients with CD20 positive acute B lymphocytic leukemia and patients with CD20 negative acute B lymphocytic leukemia. CD20 is not an independent prognostic factor for acute lymphoblastic leukemia.
引文
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[9]申淑珍,白晓川,刘娟.CDX2基因在成人急性淋巴细胞白血病中的表达及临床意义[J].宁夏医科大学学报,2016,38(1):39-42.
[10]李妍,史利欢,郭明发,等.儿童急性淋巴细胞白血病免疫分型特征及其临床意义[J].疾病监测与控制,2017,11(11):929-930.
[11]何柏林,许娜,李玉玲,等.p16基因缺失在成人Ph染色体阳性急性淋巴细胞白血病中的临床意义[J].中华血液学杂志,2017,38(3):204-209.
[12]唐艳萍,蔡政民,唐亚梅,等.表达融合基因的急性B淋巴细胞白血病患者形态学和免疫表型特点[J].现代肿瘤医学,2017,25(7):1097-1100.
[13]朱正坤,高新年.慢性B淋巴细胞白血病免疫表型的诊断研究[J].医学综述,2016,22(11):2191-2193.
[14]任振波,候毅锐,郑伟,等.表达CD20的正常B细胞对CD20特异cTCR^+T细胞抗白血病活性的影响[J].中国实验诊断学,2017,21(2):326-328.
[15]任羽,贺爱军,葛繁梅.急性淋巴细胞白血病nm23-H1蛋白的表达及其同免疫分型的相关性[J].湖南师范大学学报(医学版),2016,13(2):96-99.
[2]Eyad A,Othman MAK,Melo JB,et al.BIRC3 alterations in chronic and B-cell acute lymphocytic leukemia patients[J].Oncology Letters,2016,11(5):3240-3246.
[3]张之南,沈悌血液病诊断及疗效标准[M].第3版.北京:科学出版社,2007:106-134.
[4]刘蒙,黄金文,姜浩.CD20阳性Ph阴性成人急性前B淋巴细胞白血病1例并文献复习[J].全科医学临床与教育,2017,14(3):344-347.
[5]张向臣,刘卫华,张秀莲.CD20在成人急性B淋巴细胞白血病中的表达价值[J].中国卫生标准管理,2016,7(5):158-159.
[6]徐智芳,任方刚,张轶群,等.CD13在费城染色体阴性急性B淋巴细胞白血病中的表达及其临床意义[J].白血病·淋巴瘤,2016,25(8):465-470.
[7]王继英,刘燕,宋振,等.急性B淋巴细胞白血病患者初发和化疗后微量残留白血病细胞免疫表型的比较[J].检验医学,2016,31(6):467-473.
[8]谢晓晴,王卫敏,甘思林,等.CD146在儿童与成人急性B淋巴细胞白血病细胞中表达及其意义[J].中国实验血液学杂志,2017,25(1):30-34.
[9]申淑珍,白晓川,刘娟.CDX2基因在成人急性淋巴细胞白血病中的表达及临床意义[J].宁夏医科大学学报,2016,38(1):39-42.
[10]李妍,史利欢,郭明发,等.儿童急性淋巴细胞白血病免疫分型特征及其临床意义[J].疾病监测与控制,2017,11(11):929-930.
[11]何柏林,许娜,李玉玲,等.p16基因缺失在成人Ph染色体阳性急性淋巴细胞白血病中的临床意义[J].中华血液学杂志,2017,38(3):204-209.
[12]唐艳萍,蔡政民,唐亚梅,等.表达融合基因的急性B淋巴细胞白血病患者形态学和免疫表型特点[J].现代肿瘤医学,2017,25(7):1097-1100.
[13]朱正坤,高新年.慢性B淋巴细胞白血病免疫表型的诊断研究[J].医学综述,2016,22(11):2191-2193.
[14]任振波,候毅锐,郑伟,等.表达CD20的正常B细胞对CD20特异cTCR^+T细胞抗白血病活性的影响[J].中国实验诊断学,2017,21(2):326-328.
[15]任羽,贺爱军,葛繁梅.急性淋巴细胞白血病nm23-H1蛋白的表达及其同免疫分型的相关性[J].湖南师范大学学报(医学版),2016,13(2):96-99.