CD25在急性B淋巴细胞白血病中的表达及其临床意义探讨

本研究旨在通过流式细胞术标记CD25，探讨其与急性B淋巴细胞白血病（B—ALL）的关系及其临床意义。选择88例初发B—ALL患者骨髓，应用流式细胞术检测免疫表型标记，包括白介素2受体α链（CD25）、B链（CD122）、Y链（CD132），CD19、CD20、CD10、CD34、CDIgM、CD79a、CD22、CDTDT；用定性PCR方法检测BCR／ABL融合基因表达，实时定量PCR检测IL2RA（CD25基因）的表达。结果表明，CD25＋和CD25-的B—ALL患者白细胞计数（WBC）、血红蛋白（Hb）、血小板（Plt）、骨髓原始细胞比例（marrowblast％）、外周血原始细胞比例（peripheralblast％）、肝脾和淋巴结肿大、cD10、cD20、cD22、cD34、CD79a、CDTDT、CDIgM表达水平差别均无统计学意义（P〉0．05），而CD19在CD25＋组中表达水平高于CD25-组（P〈0．05）。本组BCR／ABL＋患者为21例（23．9％，21／88），CD25＋表达率为66．7％（14／21）；BCR／ABL-患者为67例，CD25＋表达率为4．5％（3／67），两组间差别有统计学意义（P〈0．05）。IL2RA基因mRNA表达水平在CD25＋和CD25-两组间无统计学差异（P〉0．05）。21例BCR／ABL＋B—ALL患者中，CD25＋与CD25-两组间在缓解率和复发率方面差异无统计学意义（P〉0．05）。BCR／ABL＋B—ALL患者中有8例复发，复发率为38．1％（8／21），BCR／ABL。组有9例复发，复发率为13．4％（9／67），两组间差异有统计学意义（P〈0．05）。BCR／ABL＋组无复发生存时间（relapse—freesurvival，RFS）为21个月，BCR／ABL＋CD25＋患者RFS时间为15个月，而BCR／ABL＋CD25-患者RFS时间为21个月，BCR／ABL—CD25-患者RFS时间为24个月。结论：CD25在BCR／ABL＋B-ALL上患者中呈高水平表达，可以作为B—ALL的BCR／ABL融合基因表达的预测指标，与疾病复发有关，CD25＋可以作为判断B—ALL不良预后的辅助标志。

Expression of CD25 in Acute B Cell Lymphoblastic Leukemia and Its Clinical Significance

This study was purposed to investigate the relation of CD25 with the acute B cell lymphoblastic leukemia （B-ALL） and its clinical significance. A totol of 88 newly diagnosed B-ALL patients were enrolled in this study. The immunophenotype of leukemic myeloblasts were detected by flow cytometry, including interleukin 2 receptor ct chain （ CD25 ）, β chain（ CD122）, γ chain （ CD132 ）, CD19, CD20, CD10, CD34, CDIgM, CD79a, CD22 and CDTDT. The expression of BCR/ABL fusion gene was detected by qualitative PCR. The erpression of IL2RA （ CD25 gene） was detected by real-time qualitative RT-PCR. The results showed that there was no significant statistical difference in WBC count, Hb level, PLT count, marrow blast rate, peripheral blast rate, hepatolienal infiltration, lymphonode infiltration, levels of CD10, CD20, CD22, CD34, CD79a, CDTDT, CDIgM expression between B-ALL patients with CD25＋ and B-ALL patients with CD25 -, while the CD19 expression level in B-ALL patients with CD25 ＋ was higher than that in B- ALL patients with CD25 -. Out of 88 B-ALL patients, 21 patients showed BCR/ABL ＋ （ 21/88 ） and their CD25 ＋ expression level was 66. 7% （ 14/21 ） ; 67 patients showed BCR/ABL- and their CD25 ＋ expression level was 4.5% （3/ 67 ）, there was statistical defference between these two groups （ P 〈 0.05 ）, but the expression level of IL2RA mRNA was not statistical different between CD25 ＋ and CD25 - groups （P 〉0.05）. Among 21 BCR/ABL＋ B-ALL patients the remission rate and relapsed rate were not statistical different between CD25 ＋ an CD25 - groups. In BCR/ABL ＋ B-ALL patients 8 patients relapsed,the relapsed rate was 38. 1% （8/21）. In BCR/ABL- B-ALL patients 9 patients relapsed, therelapse rate was 13.4% （9/67） ,there was statistical difference between BCR/ABL＋ and BCR/ABL- two groups （P 〈0. 05）. In BCR/ABL＋ group the RFS （relapse free survival） was 21 months, in BCR/ABL＋ CD25 ＋ patients the RFS was 15 months, while in BCR/ABL ＋ CD25 - patients the RFS was 21 months, in BCR/ABL- CD25 - patients, the RFS was 24 months. It is concluded that the CD25 expresses at high level in B-ALL patients with BCR/ABL ＋ , which may serve as a predictive marker for the presence of BCR/ABL fusion gene, and relates with relapse, CD25 ＋ may serve as a adjuvant indicator for poor prognosis.relapse rate was 13.4% （9/67） ,there was statistical difference between BCR/ABL＋ and BCR/ABL- two groups （P 〈0. 05）. In BCR/ABL- group the RFS （relapse free survival） was 21 months, in BCR/ABL- CD25 ＋ patients the RFS was 15 months, while in BCR/ABL - CD25 - patients the RFS was 21 months, in BCR/ABL- CD25 - patients, the RFS was 24 months. It is concluded that the CD25 expresses at high level in B-ALL patients with BCR/ABL - , which may serve as a predictive marker for the presence of BCR/ABL fusion gene, and relates with relapse, CD25 ＋ may serve as a adjuvant indicator for poor prognosis.