中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2011年
46期
3267-3270
,共4页
于珍%李增军%易树华%周可树%郝牧%李长虹%齐军元%邱录贵
于珍%李增軍%易樹華%週可樹%郝牧%李長虹%齊軍元%邱錄貴
우진%리증군%역수화%주가수%학목%리장홍%제군원%구록귀
白血病,淋巴细胞,慢性%预后%典型模式B细胞受体
白血病,淋巴細胞,慢性%預後%典型模式B細胞受體
백혈병,림파세포,만성%예후%전형모식B세포수체
Leukemia,lymphocytic,chronic%Prognosis%Stereotyped B-cell receptor
目的 探讨我国慢性淋巴细胞白血病(CLL)患者典型模式B细胞受体(stereotyped BCR)的表达情况及其预后价值.方法 应用多重PCR方法检测1992年4月至2010年4月中国医学科学院北京协和医学院血液学研究所116例CLL患者免疫球蛋白重链可变区(IGHV)片段使用情况及突变状态,应用多序列比对软件ClustalW2明确我国典型模式BCR的表达情况,并与CLL患者IGHV突变状态、细胞遗传学异常、生存和预后进行相关性分析.结果 共检测初诊CLL患者116例,102例成功测序,检出率87.9％.测序反应共得到73例患者的IGHV互补决定区3(CDR3)序列,19.2％(14例)CLL患者BCR为典型模式.与IGHV突变组相比,未突变组患者中典型模式BCR的发生率更高(40.9％比11.8％,P=0.005).BCR为典型模式的CLL患者中17q-的发生率更高(33.3％比10.7％,P=0.045).BCR为典型模式的CLL患者的中位无进展生存时间(PFS)较其他组为短(39个月比84个月,p =0.002).结论 BCR为典型模式的CLL患者预后较差.典型模式BCR的存在表明肿瘤细胞曾面临同样的抗原选择过程,提示抗原选择与CLL的发生密切相关.
目的 探討我國慢性淋巴細胞白血病(CLL)患者典型模式B細胞受體(stereotyped BCR)的錶達情況及其預後價值.方法 應用多重PCR方法檢測1992年4月至2010年4月中國醫學科學院北京協和醫學院血液學研究所116例CLL患者免疫毬蛋白重鏈可變區(IGHV)片段使用情況及突變狀態,應用多序列比對軟件ClustalW2明確我國典型模式BCR的錶達情況,併與CLL患者IGHV突變狀態、細胞遺傳學異常、生存和預後進行相關性分析.結果 共檢測初診CLL患者116例,102例成功測序,檢齣率87.9％.測序反應共得到73例患者的IGHV互補決定區3(CDR3)序列,19.2％(14例)CLL患者BCR為典型模式.與IGHV突變組相比,未突變組患者中典型模式BCR的髮生率更高(40.9％比11.8％,P=0.005).BCR為典型模式的CLL患者中17q-的髮生率更高(33.3％比10.7％,P=0.045).BCR為典型模式的CLL患者的中位無進展生存時間(PFS)較其他組為短(39箇月比84箇月,p =0.002).結論 BCR為典型模式的CLL患者預後較差.典型模式BCR的存在錶明腫瘤細胞曾麵臨同樣的抗原選擇過程,提示抗原選擇與CLL的髮生密切相關.
목적 탐토아국만성림파세포백혈병(CLL)환자전형모식B세포수체(stereotyped BCR)적표체정황급기예후개치.방법 응용다중PCR방법검측1992년4월지2010년4월중국의학과학원북경협화의학원혈액학연구소116례CLL환자면역구단백중련가변구(IGHV)편단사용정황급돌변상태,응용다서렬비대연건ClustalW2명학아국전형모식BCR적표체정황,병여CLL환자IGHV돌변상태、세포유전학이상、생존화예후진행상관성분석.결과 공검측초진CLL환자116례,102례성공측서,검출솔87.9％.측서반응공득도73례환자적IGHV호보결정구3(CDR3)서렬,19.2％(14례)CLL환자BCR위전형모식.여IGHV돌변조상비,미돌변조환자중전형모식BCR적발생솔경고(40.9％비11.8％,P=0.005).BCR위전형모식적CLL환자중17q-적발생솔경고(33.3％비10.7％,P=0.045).BCR위전형모식적CLL환자적중위무진전생존시간(PFS)교기타조위단(39개월비84개월,p =0.002).결론 BCR위전형모식적CLL환자예후교차.전형모식BCR적존재표명종류세포증면림동양적항원선택과정,제시항원선택여CLL적발생밀절상관.
Objective To investigate the expression pattern of stereotyped B-cell receptor(BCR)and its prognostic significance in Chinese chronic lymphocytic leukemia(CLL)patients and evaluate the relationship to other prognostic markers.Methods Multiplex polymerase chain reaction(PCR)was used to identify the immunoglobulin vaiiable heavy-chain(IGHV)segment and its mutation status in 116 CLLpatients from April 1992 to April 2010.For CDR3-driven clustering,all in-frame IGHV-D-J rearrangements were aligned by the multiple sequence alignment software ClustalW2.Results There were 102 of 116 samples from newly diagnosed CLL were successfully analyzed.IGHV CDR3 genes were identified in 73/102 cases.Fourteen patients(19.2％)carried stereotyped BCR.A high percentage of carried stereotyped BCR was observed in 1GHV non-mutated group versus mutated group(40.9％ vs 11.8％,P =0.005).Patients with stereotyped BCR had a higher frequency of deletion(17q)(33.3％ vs 10.7％,P =0.045).The median progression-free survival(PFS)in patients with stereotyped BCR was much shorter than other patients(39 vs 84 months,P =0.002).Conclusion The patients with stereotyped BCR have a poor prognosis.It highlights the importance of immunoglobulin mediated stimulation in the development of CLL.
