CAJ | 학술논문

目的研究淋巴细胞功能相关抗原-3(LFA-3、CD58)在成人急性B淋巴细胞白血病(B-ALL)中的表达,并探讨联合CD19、CD34、CD20、CD10和 CD45等免疫分子用于成人B-ALL微小残留病(MRD)监测的可行性,以及CD58对于成人B-ALL预后的意义。方法选取CD10/CD58/CD19/CD45和CD34/CD20/CD45抗体组合,应用多参数流式细胞术(FCM)检测36例缺铁性贫血治疗后(对照组)和39例 B-ALL初诊及治疗后(实验组)患者的骨髓标本。根据抗体表达规律将对照组正常分化的B系前体细胞分成早期、中期和成熟3个阶段；实验组白血病细胞按CD58的平均荧光强度(MFI)分为高表达组与低表达组。分别比较CD58在对照组和实验组不同阶段或组别表达强度差异。结果正常分化的B系前体细胞CD58表达强度整体呈现低表达水平。高表达组异常细胞 CD58表达强度显著高于对照组( P <0.05)；同时低表达组异常细胞CD58表达强度与对照组比较,差异无统计学意义。治疗后共有32例患者定期监测骨髓MRD,监测12个月数据表明：高表达组8例MRD阳性, CD58 MFI为(25.19±3.57),15例MRD阴性,CD58 MFI为(5.25±1.23)；低表达组7例MRD阳性,CD58 MFI为(6.96±0.94),2例MRD阴性,CD58 MFI为(6.80±1.27)。结论CD58在异常细胞的表达强度稳定,联合 CD19、CD34、CD20、CD10和CD45抗体组合可以用于CD58高表达组B-ALL患者MRD的监测,其表达强度的高低对于治疗效果评估具有很好的提示作用,即CD58低表达提示化疗效果不理想,预后不良。
목적연구림파세포공능상관항원-3(LFA-3、CD58)재성인급성B림파세포백혈병(B-ALL)중적표체,병탐토연합CD19、CD34、CD20、CD10화 CD45등면역분자용우성인B-ALL미소잔류병(MRD)감측적가행성,이급CD58대우성인B-ALL예후적의의。방법선취CD10/CD58/CD19/CD45화CD34/CD20/CD45항체조합,응용다삼수류식세포술(FCM)검측36례결철성빈혈치료후(대조조)화39례 B-ALL초진급치료후(실험조)환자적골수표본。근거항체표체규률장대조조정상분화적B계전체세포분성조기、중기화성숙3개계단；실험조백혈병세포안CD58적평균형광강도(MFI)분위고표체조여저표체조。분별비교CD58재대조조화실험조불동계단혹조별표체강도차이。결과정상분화적B계전체세포CD58표체강도정체정현저표체수평。고표체조이상세포 CD58표체강도현저고우대조조( P <0.05)；동시저표체조이상세포CD58표체강도여대조조비교,차이무통계학의의。치료후공유32례환자정기감측골수MRD,감측12개월수거표명：고표체조8례MRD양성, CD58 MFI위(25.19±3.57),15례MRD음성,CD58 MFI위(5.25±1.23)；저표체조7례MRD양성,CD58 MFI위(6.96±0.94),2례MRD음성,CD58 MFI위(6.80±1.27)。결론CD58재이상세포적표체강도은정,연합 CD19、CD34、CD20、CD10화CD45항체조합가이용우CD58고표체조B-ALL환자MRD적감측,기표체강도적고저대우치료효과평고구유흔호적제시작용,즉CD58저표체제시화료효과불이상,예후불량。
Objective To investigate the expression of CD58 in adult acute B-lymphocytic leukemia(B-ALL), and analyze the feasibility and significance of CD58 in monitoring of minimal residual disease(MRD) for adult B-ALL. Methods The combination of antibodies CD10/CD58/CD19/CD45 and CD34/CD20/CD45 were detected in bone marrow samples from 36 patients of iron deficient anemia after treatment (Control Group) and 39 patients with new-ly diagnosed B-ALL (Experimental Group) by Multi-parameter flow cytometry (FCM). According to the antibody expression, Nonmalignant B cells were designated as early, mid, and mature. Experimental Group was divided into the CD58 higher expression group and the CD58 lower expression group. Combined with clinical outcomes, the differences of CD58 expression in the Control Group and Experimental Group to assess the prompt significance of CD58 high and low expression groups for the prognosis of B-ALL. Results The mean value of CD58 showed low expression levels as a whole. The mean value of CD58 of high expression group was significantly higher than that in control group(P<0.05), while low expression group with no significant difference of B lineage precursor cells ex-pression. A total of 32 patients monitored minimal residual diseases regularly after treatment. The data of 12 months indicated:8 of high expression group showed MRD( +)MFI (25.19±3.57),while 15 of the group showed MRD (-)MFI (5.25±1.23). 7 of low expression group showed MRD( +) MFI (6.96 ±0.94), the 2 of the group showed MRD( -)MFI (6.80±1.27). Conclusion The expression of CD58 of abnormal cells was strong and sta-ble. The vast majority of patients with B-ALL leukemia cells were abnormally high expression of CD58 and the ex-pression levels were significantly higher than nonmalignant B-cell populations at any maturational stage. It is con-cluded that CD58 combined with CD19/CD34/CD20/CD10/CD45 can be used as an indicator for detection of MRD in B-ALL patients. The expression of the intensity level is a good mark of treatment assessment.