The Significance Of Diagnosis And Differential Diagnosis And Progression Of Immunophenotype Characteristic In B Cell Chronic Lymphocytic Leukemia

B cell chronic lymphocytic leukemia is a low potential malignancy hematological system tumor and one of B cell Lymphocyte proliferation dieases. The main clinical manifestation is small B lymphocytes cell increased in peripheral blood and bone marrow. However, Other types of B cell lymphocyte proliferation dieases can also have the same clinical symptoms, for example, hairy cell leukemia, the type of leukemia in non-Hodgkin lymphoma, Mantle cell lymphoma and follicular cell lymphoma, which are higher malignant diseases. There is very important that the significance of diagnosis and differential diagnosis of B cell chronic lymphocytic leukemia.The main diagnosis of B-cell chronic lymphocytic leukemia basis clinical symptoms, cell morphology and cell immunophenotyping. There is very difficult to diagnosis, Beca use of lack of specificity clinical symptoms. The role has fully confirmed in bone marr ow cell morphology. There are still some limitations to distinguish between cell deriv ed and immune subtype in bone marrow cell morphology. Flow cytometry (FCM) can determination of cell antigen expression, rapidly and objectively. Learn the cell series and the degree of differentiation in leukemia cell. FCM has become an important means of diagnose B-cell chronic lymphocytic leukemia.Objective①To investigate the difference between our country and western countries of B cell chronic lymphocytic leukemia in immunophenotype characterist. ②To investigate the differential diagnosis of immunophenotype characteristic of B-cell chronic lymphocytic leukemia.Methods Two or three color monoclonal antibodies directly labeled with immunofluorescence were used to analyze the surface and cytoplasma antigens (such as CD2,CD5,CD7,CD10,CD13,CD19,CD20,CD23,CD33 and sIgM et al.) by multiparameter flow cytometry with 38 B-CLL and 3 HCL and 2 MCL and B-PLL patients by multiparameter flow cytometry.Results①The 38 cases of B-CLL expressed the phenotypes: expressed CD5+CD19+ 32 cases(84.2%), CD20 and CD23, CD20 weakly positive 30 cases(93.7%), CD23+ 24 cases(75%)and sIgM+ 20 cases(66.7%). 6 cases unexpress CD5+CD19+, CD23+ 4 cases(66.7%), CD20+ 3 cases (50.0%)and 1 sIgM+ (16.7%);②3 HCL patients all CD5-, 2 cases found both CD25+.③1 CD5+ 2 CD23- in 2 B-PLL patients.④2 MCL cases express CD5, CD19 and CD20, unexpress CD23, CD20 and sIgM strong positive.Conclusion①3 8 cases diagnosed with B-CLL disease CD5+CD19+ 84.2% lower than the reported foreign 95%. And 6 cases B-CLL unexpress CD5+CD19+, the positive expression of CD19,CD20,CD23 and sIgM has reported in line with foreign.②The disease of MCL express CD5+CD19+, unexpress CD23, CD20 and sIgM Strong positive expression of agreement with foreign reports.③The disease of HCL unexpress CD5+CD19+, Specific expression CD25 has agree with foreign reports.④The disease of B-PLL has agreement with the expression of CD19 and CD20, unexpression of CD23 and CD5. B-cell chronic lymphocytic leukemia is a highly heterogeneous disease. Their natural life like normal people without specific treatment; however, some patients with rapid progress and short survival time. It is reported that low-risk patients with asymptomatic have no improvement in their survival with early treatment of chemotherapy drugs, overly aggressive treatment may increase its side effects. With modern technology and medical examination and the improvement of treatment conditions. Some patients have not yet been diagnosed before symptoms. So, how to make an accurate diagnosis in the early stage, and how to make a reasonable classification based on effective prameters on the prognosis of the disease. It is very important that to improve the quality of life and selection of clinical treatment.Traditional to determine the parameters of the prognosis of B-CLL patients , such as disease stage, peripheral blood lymphocyte count, the degree of bone marrow infiltration, et al. Studies have shown that patients with good prognosis of lymphocyte count <5.0×109/L, no bone marrow infiltration, the time of lymphocyte doubling >12 month ,the stage of Binet A or Rai 0 and 1. However, there is still one of 10% have rapid progression. The various parameters in the above-mentioned, it is a valuable indicators of overall survival, such as the disease stage and the degree of bone marrow infiltration. But we can not predict the progress of the disease risk in patients with early stage. So, it is particularly important that to find prognostic indicators of molecular biology, at the early stages of the disease. 2006, The United States National Comprehensive Cancer Network (NCCN) clinical guidelines define: CD38-positive patients with poor prognosis, CD38-negative patients with good prognosis. In B-CLL, its clinical staging of patients with ZAP-70 positive later and poor than ZAP-70 negative.Objective To investigate the relationship between disease progression of ZAP-70 and CD38 and CD23 in B-cell chronic lymphocytic leukemia.Methods Monoclonal antibodies directly labeled with immunofluorescence were used to analyze the surface and cytoplasma antigens (such as CD38 and ZAP-70) with 52 patients by multiparameter flow cytometry.Results①Phased in accordance with Binet, B-CLL patients divided into 2 groups: 18 cases of Binet A ; 34 cases of Binet B+C. and test for CD23 with 52 patinets and CD38 with 37 cases and ZAP-70 with 25 cases. Group one: 18 cases of Binet A , 13 cases CD23 positive, 14 and 16 cases are CD38 and ZAP-70 negative. Group two : 34 cases of Binet B+C, 11 cases are negative of CD23,CD38 positive 10 csaes and ZAP-70 3 cases.②CD23 positive 36 csaes (69.2%), 13 cases of Binet A . CD23 negative 16 cases(30.8%), 23 cases of Binet B+C, 5 cases of Binet A , 11 cases of Binet B+C(P>0.05).③37 cases have tested for CD38 in 52 B-CLL patients. CD38 positive 14 csaes(37.8%), 10 cases of Binet B+C(71.4%), only 4 were Binet A(28.6%); CD38 negative 23 cases(62.2%),14 cases of Binet A(60.9%),9 cases of Binet B+C(39.1%) (P<0.05).④25 cases make the test of ZAP-70, positive with 4 csaes(16%), 3cases of Binet B+C; ZAP-70 negative 21 cases(84%),16 cases of Binet A(P>0.05).Conclusion The late clinical stage and bad prognosis of the expression with CD38 and ZAP-70 positive.