Ki-67在CLL的表达及其临床意义  

Expression of Ki-67 in Chronic Lymphocytic Leukemia and Its Clinical Significance

作　　者：谭明芳[1] 张正昊[1] 余静静[1] 曲建华[1] 

机构地区：[1]新疆医科大学第一附属医院血液病中心,新疆乌鲁木齐830054

出　　处：《中国实验血液学杂志》2015年第2期318-321,共4页Journal of Experimental Hematology

基　　金：新疆维吾尔自治区自然科学基金(2013211A100)

摘　　要：目的:研究慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)患者骨髓细胞Ki-67的表达,并探讨Ki-67的临床意义与其他指标的关系。方法:回顾性分析26例已经确诊的患者,应用免疫组织化学染色方法检测Ki-67在骨髓细胞中的表达,运用流式细胞技术检测Zeta链相关蛋白-70(Zeta chain-associated protein,ZAP70)、CD38等相关指标,联合应用序列特异性探针RB1(13q14)、ATM(11q22.3)、P53(17p13.1)和着丝粒探针CSP12(+12)间期荧光原位杂交(fluorescence in situ hybridization,FISH)技术检测细胞遗传学变化。结果:26例患者中15例(57.7%)Ki-67表达阳性,11例(42.3%)中Ki-67表达阴性,平均阳性表达率(10.86±7.36)%。Ki-67水平与性别、年龄、血红蛋白、血小板、ZAP70、ATM、β-2微球蛋白、+12、免疫球蛋白重链(Immunoglobulin heavy chain,Ig HV)、P53无相关性,与Rai分期(P=0.01,r=0.517)、CD38(P=0.02,r=0.469)、13q14(P=0.021,r=-0.48)有相关性,差异有统计学意义。结论:Ki-67在CLL进展期的患者中检出率较高,Ki-67与Rai分期、CD38、13q14有相关性;Ki-67表达的高低可以作为指导治疗的指标。Objective： To investigate the expression of nuclear antigen Ki-67 in CLL patients and realationship of Ki- 67 expression with other clinical parameters. Methods： Twenty-Six confirmed cases of CLL were analysised retrospectively. The immhnohistochemical method was carded out to examine the expression of Ki-67 in bone marrow cells, the flow cytometer was used to detect ZAP70 （Zeta chain-associated protein）, CD38 and other markers, additionally, a panel of probes RB1 （ 13q14）, ATM （ 11q22. 3 ）, P53 （ 17p13. 1 ） and CSP12 （ ＋ 12 ） FISH were perfomed to detect the cytogenetic abnormalities. Results： Out of 26 patients, 15 cases （57.7%） showed positive expression of Ki-67, 11 cases （42.3%） showed negative expression of Ki-67, the average rate of Ki-67 positive expression was （ 10.86 ＋7. 36） %. The level of Ki-67 did not relate with sex, age, Hb, platelet, ZAPT0, ATM. 1-2 - MG, IgHV and P53, but related to the Ral staging （ P = 0.01, r = 0. 517 ）, CD38 （ P = 0.02, r = 0. 469 ）, 13q14 （ P = 0. 021, r = - 0.48 ）, and there was statistically significant difference （ P 〈 0.05 ）. Conclusion： The Ki-67 level is higher in progressive stage of CLL and the Ki-67 expression is related with Rai staging, CD38, 13q14. The expression level of Ki-67 may be used as indicator for evaluation of CLL prognosis and guiding treatment for this disease.

关 键 词：KI-67 慢性淋巴细胞白血病 骨髓细胞 ZAP70 Rai分期 

分 类 号：R733.72[医药卫生—肿瘤]