Davis Bruce H, Schwartz Michael
US Labs, Irvine, CA, USA.
Cytometry B Clin Cytom. 2006 Jul 15;70(4):315-9. doi: 10.1002/cyto.b.20130.
Zeta-associated protein (ZAP-70) expression has been associated with a less favorable prognosis in chronic lymphocytic leukemia (CLL). The role of ZAP-70 in immature B-cells is not well understood. Immature or precursor B lymphocytes (hematogones) often occur in clinical samples and coexpress CD10, CD38, and CD19 lacking surface immunoglobulin expression. The present study was carried out in an attempt to further elucidate the role of ZAP-70 in the spectrum of B-cells seen in clinical specimens.
ZAP-70 expression was evaluated on 25 patient samples that expressed greater than 2% of CD10(+)/CD38(bright)/CD19(+) coexpression during routine evaluation. In our sample set, the hematogone expression ranged from 2 to 18% of total leukocytes and occurred in a variety of conditions, including CLL, NHL, AML, MDS, Hodgkins Disease, and Multiple Myeloma. The method of ZAP-70 detection was that routinely applied to our clinical testing of CLL samples supplemented with the determination of ZAP-70 levels in the CD38(bright)/CD19(+) coexpressing cells.
In all cases ZAP-70 was not expressed on the CD5 negative, CD38/CD19 coexpressing precusor B cells. In all cases hematogones were found to not express significant levels of ZAP-70.
The presence of hematogones in clinical samples should be recognized so as to not adversely influence prognostic studies of ZAP-70 or CD38 in CLL.
ζ相关蛋白（ZAP-70）表达与慢性淋巴细胞白血病（CLL）预后较差相关。ZAP-70在未成熟B细胞中的作用尚不清楚。未成熟或前体B淋巴细胞（造血细胞）常在临床样本中出现，共表达CD10、CD38和CD19且缺乏表面免疫球蛋白表达。本研究旨在进一步阐明ZAP-70在临床标本中所见B细胞谱系中的作用。
在25例患者样本中评估ZAP-70表达，这些样本在常规评估期间表达大于2%的CD10(+)/CD38(明亮)/CD19(+)共表达。在我们的样本集中，造血细胞表达占总白细胞的2%至18%，并出现在多种病症中，包括CLL、非霍奇金淋巴瘤（NHL）、急性髓细胞白血病（AML）、骨髓增生异常综合征（MDS）、霍奇金病和多发性骨髓瘤。ZAP-70检测方法是常规应用于我们对CLL样本的临床检测，并补充测定CD38(明亮)/CD19(+)共表达细胞中的ZAP-70水平。
在所有病例中，ZAP-70在CD5阴性、CD38/CD19共表达的前体B细胞上均未表达。在所有病例中，均发现造血细胞不表达显著水平的ZAP-70。
应认识到临床样本中造血细胞的存在，以免对CLL中ZAP-70或CD38的预后研究产生不利影响。
