CD38表达在侵袭性B细胞淋巴瘤诊断中的价值

朱明霞; 万文丽; 洪韫; 李敏; 胡凯; 王艳芳; 克晓燕; 景红梅

doi:10.13201/j.issn.1004-2806.2020.01.008

CD38表达在侵袭性B细胞淋巴瘤诊断中的价值

- 北京大学第三医院血液科(北京, 100191);
- 2. 北京大学第三医院病理科

详细信息

通讯作者: 景红梅,E-mail:hongmei_jing@163.com

中图分类号: R733.4

收稿日期: 2019-10-15

Bright CD38 expression by flow cytometric analysis in diagnosis of aggressive B cell lymphomas

- 1 Department of Hematology, Peking University Third Hospital, Beijing, 100191, China;
- 2 Department of Pathology, Peking University Third Hospital, Beijing

More Information

Corresponding author: JING Hongmei, E-mail: hongmei_jing@163.com

Received Date: 15 October 2019

摘要

摘要: 目的:探讨CD38表达在侵袭性B细胞淋巴瘤诊断和鉴别诊断中的意义。方法:应用多参数流式细胞术检测102例初发侵袭性B细胞淋巴瘤[主要包括弥漫大B细胞淋巴瘤(DLBCL)73例、Burkitt淋巴瘤7例和高级别B细胞淋巴瘤22例]患者淋巴结或骨髓标本中流式免疫标记物的表达情况,比较CD38在各组患者肿瘤细胞上表达水平的差异,分析其在侵袭性B细胞淋巴瘤鉴别诊断中的特点。结果:3组患者肿瘤细胞膜表面CD5、CD19^dim、CD20^dim和CD45^dim表达水平差异无统计学意义(均P＞0.05),CD10表达水平以及缺乏免疫蛋白轻链表达差异有统计学意义(P=0.029,P=0.043);将DLBCL分为MYC-R⁺和MYC-R^-患者,CD38⁺、CD38⁺⁺和平均荧光强度在DLBCL MYC-R⁺、DLBCL MYC-R^-、Burkitt淋巴瘤和双重/三重打击淋巴瘤4组患者肿瘤细胞表达水平差异有统计学意义(均P＜0.05),CD38⁺在诊断这4组侵袭性B细胞淋巴瘤时除DLBCL MYC-R⁺外特异性可达100%,但敏感性较低;CD38⁺⁺诊断DLBCL MYC-R⁺时特异性可达100%,敏感性低至13%,而诊断Burkitt淋巴瘤和双重/三重打击淋巴瘤时敏感性则明显升高(分别为86%和79%)。结论:CD38不同表达水平在侵袭性B细胞淋巴瘤鉴别诊断中具有重要作用,尤其CD38高表达可以及时准确地早期诊断双重/三重打击淋巴瘤,对临床治疗具有指导意义。
- CD38 /
- 侵袭性B细胞淋巴瘤 /
- 多参数流式细胞术 /
- 双重/三重打击淋巴瘤
Abstract: Objective:To investigate the expression level and clinical significance of CD38 in the diagnosis of aggressive B cell lymphomas.Method:Several cytometric markers were detected in the lymph nodes and bone marrows by flow cytometry in 102 newly diagnosed aggressive B cell lymphoma patients,including 73 patients with diffuse large B-cell lymphoma(DLBCL),7 patients with Burkitt lymphoma(BL) and 22 patients with high-grade B cell lymphoma.We compared the expression levels of CD38 on the lymphoma cells in each group,and further analyzed the significance of CD38 expression in the differential diagnosis among aggressive B cell lymphomas.Result:Of the flow cytometric parameters assessed,the expression levels of CD5⁺,CD19^dim+,CD20^dim+ and CD45^dim+ showed no statistically significant differences among three groups(P＞0.05).Significant differences were observed in expression of CD10⁺ and lacking surface immunoglobulin light chain among these three groups(P=0.029,P=0.043).Bright CD38 expression(CD38⁺),very bright CD38 expression(CD38⁺⁺) and median fluorescence intensity of CD38 showed statistically significant differences among four groups including DLBCL MYC-R⁺,DLBCL MYC-R^-,BL and DHL/THL patients.CD38⁺ diagnosed these aggressive B cell lymphomas except for DLBCL MYC-R⁺ with very high specificities(100%) and very low sensitivities. The specificity of CD38⁺⁺ in the diagnosis of DLBCL MYC-R⁺ was 100% and the sensitivity was low to 13%, while CD38⁺⁺ was a significant diagnostic biomarker associated with BL and DHL/THL with higher sensitivities(86% and 79%,respectively).Conclusion:Different expression levels of CD38 could play an important role in the differential diagnosis among aggressive B cell lymphomas,especially bright CD38 expression(CD38⁺) might early and accurately diagnose DHL/THL and help to guide clinical treatment.
- CD38 /
- aggressive B cell lymphomas /
- multiparameter flow cytometry /
- double/three hit lymphomas

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