慢性淋巴细胞白血病外周血免疫球蛋白异常研究  

Abnormality of Serum Immunoglobulin in Peripheral Blood of Patients with Chronic Lymphocytic Leukemia

作　　者：朱远东[1] 徐卫[1] 缪扣荣[1] 曹鑫[1] 范磊[1] 刘琼[1] 姚琳[1] 吴雨洁[1] 洪鸣[1] 李建勇[1] 

机构地区：[1]南京医科大学第一附属医院江苏省人民医院血液科,南京210029

出　　处：《中国实验血液学杂志》2009年第5期1159-1162,共4页Journal of Experimental Hematology

基　　金：国家自然科学基金资助项目(编号30871104);江苏省医学领军人才基金资助项目(编号LJ200623);江苏省医学重点人才基金资助项目(编号RC2007042);江苏省自然基金资助项目(编号BK2007249);江苏省"青蓝工程"中青年学术带头人培养对象项目;江苏省"六大人才高峰"资助项目

摘　　要：为了解慢性淋巴细胞白血病(CLL)患者外周血免疫球蛋白(Ig)异常与年龄、性别、疾病分期及预后的关系,运用免疫速率比浊法测定83例CLL患者血清中IgG、IgA和IgM水平,用多参数流式细胞术(FCM)检测患者外周血CD38、ZAP-70表达水平。结果表明:83例CLL患者中IgG减低12例(14.5%);IgA减低26例(31.3%),IgM减低34例(41.0%)。BinetC期组Ig减低发生率明显高于BinetA和B期组(p=0.011),Rai分期高危组的Ig减低发生率明显高于低危组(p=0.011)。Ig减低组CD38和ZAP-70表达阳性率明显较Ig正常组高(p=0.033和p=0.038)。CD38和ZAP-70在疾病晚期患者表达阳性率更高,其中BinetC期组ZAP-70表达阳性率明显高于BinetA和B期组(p=0.047)。而年龄和性别与Ig异常没有明显相关性(p>0.05)。结论:CLL患者体液免疫功能与疾病分期密切相关,检测CLL患者外周血Ig水平的变化,对了解CLL患者免疫功能状态,从而判断病情及预后具有重要作用。In order to investigate the relation of serum immunoglobulin （Ig） level to age, sex, disease stages and prognosis in chronic lymphocytic leukemia （CLL） patients, the levels of serum IgG, IgA and lgM in 83 CLL patients were detected by immune rate turbidimetry, the expressions of CD38 and ZAP-70 in CLL ceils were determined by multi-parameter flow cytometry （FCM）. The results showed that among the 83 CLL patients, the IgG, IgA and IgM levels were reduced in 12 （ 14.5% ）, 26 （31.3%） and 34 （41.0%） respectively. The incidence of Ig reduction was higher in Binet C stage than that in Binet A and B （p = 0. 011 ）, There was higher incidence of lg reduction in high-risk group of Rai stage than that in low-risk group （p = 0.011 ）. The positive rate of CD38 or ZAP-70 was significantly higher in Ig reduction group than that in normal Ig level group （p =0.033 and p =0.038 respectively）. The positive rate of CD38 and ZAP-70 was also higer in advanced disease, and among them the positive rate of ZAP-70 expression in Binet C stage was obviously higer than Binet A and B （p = 0.047 ）. Nonetheless, there was no significant relationship of Ig level with gender and age （p 〉 0, 05 ）, It is concluded that the function of humoral immunity in CLL patient is closely related to the disease stages. The serum Ig detection seems important for evaluating immunologic state and prognosis of CLL patients.

关 键 词：慢性淋巴细胞白血病 免疫球蛋白 外周血 

分 类 号：R733.72[医药卫生—肿瘤]