Expression of CD38 and ZAP-70 in chronic lymphocytic leukemia patients and their clinical significance / 白血病·淋巴瘤

ABSTRACT

Objective To investigate the expression of CD38 and ZAP-70 in chronic lymphocytic leukemia and the relationship between the clinical stages and prognostic significance.Methods Flow cytometry was used to analyze CD38 and ZAP-70 expression in CLL,the patients were divided into high-risk group (Ⅲ,Ⅳ stage) (25 cases) and low-medivm risk group (0,Ⅰ,Ⅱ stage) (17 cases) according to Rai clinical stages.The distribution of CD38 and ZAP-70 expression in Rai clinical stages and the prognostic significance were analyzed.Results Positive expression of CD38 was 47.6 ％ (20/42) in all patients,64.0 ％(16/25) patients in high-risk group and 23.5 ％ (4/17) in low-medium risk group.The distribution of CD38 expression had significant difference between two groups (x2 =6.645,P =0.014).Positive expression of ZAP-70 was 40.5 ％ (17/42) in all patients,60.0 ％ (15/25) patients in high-risk group and 11.8 ％ (2/17) in low-medium risk group.The distribution of ZAP-70 expression had significant difference between two groups (x 2 =9.772,P =0.003).The patients with ZAP-70+ CD38 and ZAP-70+ CD38 were more distribute in high risk campare to the CD38+ ZAP-70- in low-medium risk group (x 2=10.076,9.346,6.005,all P ＜ 0.05).Follow-up 48 months (1-136 months),the progression-free survival of patients with ZAP-70+ CD38+ and ZAP-70 CD38 were respectively for 19.0 and 58.0 months (x2 =11.488,P =0.003).The progression-free survival of ZAP-70+CD38 or ZAP-70 CD38+ were 43.5 and 51.7 months and not statistically significant (x2 =0.075, P =0.784).Conclusion CD38 and ZAP-70 positive expression occurs in large proportion of CLL patients with advanced stages (Rai Ⅲ and Ⅳ stage) and according to the clinical stages the expression of CD38 and ZAP-70 may be predicted.The current findings suggest that both ZAP-70 and CD38 expression should be assessed in patients with CLL for the definition of prognostic subgroups.