CAJ | 학술논문

本研究目的是观察CD19和CD20在急性白血病(AL)细胞中的表达与分布,为急性B系白血病靶向分子的选择提供合理依据.采用27个荧光直标单克隆抗体及CD45/SSC双参数设门多色流式细胞术对321例AL细胞进行免疫诊断和分型,并对CD19和CD20在各种类型AL细胞中的表达情况进行分析.结果表明,在116例B系ALL病例中,CD19持续稳定表达,其阳性率(115/116,99.1%)明显高于CD20(33/116,28.4%,P=0.001);在17例含B系成分的混合型白血病(acute mixed lineage leukemia,AMLL)细胞中,前者的阳性率也明显高于CD20(P＜0.01),而在29例T细胞系ALL和7例T/My HAL细胞中,两者均无表达;在152例急性髓系白血病(AML)细胞中,CD19和CD20阳性率均很低,分别为7.2%和2.0%;CD19和CD20在B-ALL及B/My AMLL组中的荧光强度差别有显著性(t=20.68,P＜0.001);CD19和CD20的特异性分别为92.3%(132/143)和92.7%(38/41),敏感性分别为99.2%(132/133)和28.6%(38/133),前者敏感性明显高于后者(X2=144.018,P=0.001).结论:CD19在B细胞系细胞的各分化阶段上持续稳定表达,反应谱比CD20宽,特异性及敏感性均高,尤其是其敏感性显著高于后者.这提示CD19抗原分子可能成为治疗B系ALL的最佳靶点.
본연구목적시관찰CD19화CD20재급성백혈병(AL)세포중적표체여분포,위급성B계백혈병파향분자적선택제공합리의거.채용27개형광직표단극륭항체급CD45/SSC쌍삼수설문다색류식세포술대321례AL세포진행면역진단화분형,병대CD19화CD20재각충류형AL세포중적표체정황진행분석.결과표명,재116례B계ALL병례중,CD19지속은정표체,기양성솔(115/116,99.1%)명현고우CD20(33/116,28.4%,P=0.001);재17례함B계성분적혼합형백혈병(acute mixed lineage leukemia,AMLL)세포중,전자적양성솔야명현고우CD20(P＜0.01),이재29례T세포계ALL화7례T/My HAL세포중,량자균무표체;재152례급성수계백혈병(AML)세포중,CD19화CD20양성솔균흔저,분별위7.2%화2.0%;CD19화CD20재B-ALL급B/My AMLL조중적형광강도차별유현저성(t=20.68,P＜0.001);CD19화CD20적특이성분별위92.3%(132/143)화92.7%(38/41),민감성분별위99.2%(132/133)화28.6%(38/133),전자민감성명현고우후자(X2=144.018,P=0.001).결론:CD19재B세포계세포적각분화계단상지속은정표체,반응보비CD20관,특이성급민감성균고,우기시기민감성현저고우후자.저제시CD19항원분자가능성위치료B계ALL적최가파점.
In order to provide the evidences for CD19 as a better antibody targeting molecule for B lineage acute leukemias than CD20 through the multi-parameter flow-cytometry analysis of leukemia cells, the samples from 321 patients with acute leukemia (AL) were immunophenotyped by multi-color flow cytometry and CD45/SSC gating strategy followed by the analysis of CD19 and CD20 expression. The results showed that the positive rate of CD19 (115/116, 99.1% ) in 116 cases with B lineage acute lymphoblastic leukemia (B lineage ALL) was significantly higher than that of CD20 (33/116, 28.4% )(P＜0.01 ); in 17 patients with B lineage/Myeloid (B/My) acute mixed lineage leukemia ( AMLL), the former positive rate ( 17/17, 100% ) was also higher than the latter (5/17, 29.4% ) (P ＜ 0.01 ). Both of the two antigens were negative in 29 patients with acute T lymphoblastic leukemia and 7 patients with T/My AMLL.The positive rates of CD19 and CD20 in 152 patients with acute myeloid leukemia (AML) were 7.2% and 2.0%, respectively. The difference of the fluorescence intensity between the two antigens on the cells from each patient with B lineage ALL or B/My AMLL was statistically significant (t = 20.68, P ＜0.001 ). The specificity of CD19 and CD20 in B lymphocytic lineage was 92.3% (132/143) and 92.7% (38/41), respectively, while the sensitivity was 99.2%( 132/133 ) and 28.6% (38/133), respectively, the former sensitivity was significantly higher than the latter ( X2 = 144.018, P =0.001 ). It is concluded that CD19 continuously and steadily express on almost all subtypes of B lineage leukemic cells with homogeneous pattern while only a small number of leukemias express CD20. Both the specificity and sensitivity of CD19 were very high with a much broader reaction pattern than that of CD20 on this group of diseases. These indicate that CD19 may be a better antibody targeting molecule than CD20 for patients with B-lineage acute leukemia.