受体酪氨酸激酶样孤儿受体1在慢性淋巴细胞白血病中的诊断价值及预后意义  

Diagnostic and prognostic value of ROR1 antigen in patients with chronic lymphocytic leukemia

作　　者：吴芬[1] 陈肖 赵四书 刘露[2] 丁家华[1] 吴雨洁[2] Wu Fen;Chen Xiao;Zhao Sishu;Liu Lu;Ding Jiahua;Wu Yujie(Department of Hematology,the Affiliated Hospital of Southeast University,Nanjing 210009,China;Department of Hematology,the First Affiliated Hospital of Nanjing Medical University(Jiangsu Provincial People′s Hospital),Nanjing 210029,China)

机构地区：[1]东南大学附属中大医院血液科,南京210009 [2]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：《中华检验医学杂志》2022年第5期502-508,共7页Chinese Journal of Laboratory Medicine

摘　　要：目的探讨受体酪氨酸激酶样孤儿受体1(ROR1)在慢性淋巴细胞白血病(CLL)中的表达及其在临床诊断中的价值,以及ROR1表达与患者遗传学和分子生物学异常的相关性。方法回顾性收集2020年11月至2021年11月于南京医科大学第一附属医院(江苏省人民医院)收治的初诊B细胞慢性淋巴增殖性疾病(B-CLPD)患者209例,其中典型免疫表型CLL 70例,不典型免疫表型CLL 16例,MCL 14例,其他类型B-CLPD 109例。应用多参数流式细胞术(FCM)检测209例患者肿瘤细胞中ROR1表达水平,采用χ^(2)检验、四格表诊断性试验分析ROR1在CLL中的诊断价值以及与患者遗传学和分子生物学异常的相关性。结果CLL患者中ROR1阳性表达率高于非CLL(78%>11%,P<0.001);典型免疫表型CLL与不典型免疫表型CLL中ROR1阳性表达率差异无统计学意义(81%>63%,P>0.05);不典型免疫表型CLL中ROR1阳性表达率高于MCL(63%>21%,P<0.05)。ROR1^(+)CLL组与ROR1-CLL组染色体核型异常检出率差异有统计学意义,ROR1^(+)CLL组复杂核型的检出率高于ROR1-CLL组(34%>14%,P<0.05)。60岁以上CLL患者ROR1阳性率更高(P<0.05)。结论ROR1可以作为CLL的辅助诊断标记物,尤其对不典型免疫表型CLL、MCL及其他类型B-CLPD的诊断及鉴别诊断有重要价值,ROR1阳性患者年龄偏高,更易检出染色体复杂核型。Objective To detect the expression of receptor tyrosine kinase-like orphan receptor 1(ROR1)antigen in chronic lymphocytic leukemia(CLL)and evaluate its diagnostic value and explore its correlation with the abnormalities of genetics and molecular biology.Methods All of 209 newly diagnosed B-cell chronic lymphoproliferative disorders(B-CLPD)patients who were admitted to the First Affiliated Hospital of Nanjing Medical University(Jiangsu Provincial People′s Hospital)from November 2020 to November 2021 were collected retrospectively,including 70 cases of CLL with typical phenotype,16 cases of CLL with atypical phenotype,14 cases of MCL,and 109 cases of other types of B-CLPD.Multi-parameter flow cytometry(FCM)was used to detect the expression levels of ROR1 in tumor cells of 209 patients.And then the diagnostic value of ROR1 in CLL patients and its correlation with the genetic and molecular biological abnormalities were analyzed by c2 test and fourfold table assessment.Results The positive expression rate of ROR1 in CLL patients was significantly higher than that in non-CLL patients(78%>11%,P<0.001);there was no significant difference of ROR1 expression between typical phenotype CLL and atypical phenotype CLL(81%>63%,P>0.05).The positive expression rate of ROR1 in atypical phenotype CLL was significantly higher than that in MCL(63%>21%,P<0.05).Additionally,there was significant difference in detection rate of chromosomal abnormalities between ROR1^(+)CLL group and ROR1-CLL group.The detection rate of complex karyotype in ROR1^(+)CLL group was higher than that in ROR1-CLL group(34%>14%,P<0.05).The CLL patients over 60 years old had higher ROR1 positive rate(P<0.05).Conclusions ROR1 can be helpful in the diagnosis of CLL,especially in the differential diagnosis of atypical phenotype CLL,MCL and other types of B-CLPD.Patients with ROR1 positive expression were older and more likely to detect complex chromosomal karyotypes.

关 键 词：白血病 淋巴细胞 慢性 B细胞 淋巴瘤 受体酪氨酸激酶样孤儿受体 诊断 核型 流式细胞术 

分 类 号：R733.72[医药卫生—肿瘤]