Xu Wei, Cao Xin, Miao Kou-Rong, Qiao Chun, Wu Yu-Jie, Liu Qiong, Fan Lei, Li Jian-Yong
Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, 210029, Nanjing, China.
Int J Hematol. 2009 Sep;90(2):205-211. doi: 10.1007/s12185-009-0380-8. Epub 2009 Jul 24.
Chronic lymphocytic leukemia (CLL) shows a remarkable heterogeneity, with some patients having an almost normal lifespan, others surviving only several months after diagnosis despite intensive therapy. The aim of this study was to investigate the serum thymidine kinase 1 (TK1) concentration in Chinese patients with CLL and its correlation with well-established other prognostic factors. Enhanced chemiluminescent dot blot assay was performed to measure serum TK1 concentration in 80 CLL patients. The concentration of TK1 was significantly increased in patients with Binet C (P = 0.002), higher levels of serum lactate dehydrogenase (LDH) (P = 0.012) and beta2-microglobulin (beta2-MG) (P = 0.025), unmutated IGHV status (P < 0.001), or higher expression levels of ZAP-70 (P = 0.014) and CD38 (P = 0.018) groups compared to the patients with Binet A, lower levels of serum LDH and beta2-MG, mutated IGHV status, or lower expression levels of ZAP-70 and CD38 groups, respectively. Strong correlation of TK1 level with IGHV mutations (r = 0.412, P < 0.001) or ZAP-70 (r = 0.263, P = 0.024) was observed. According to receiver operating characteristic curve analysis for serum TK1 concentration and IGHV mutational status, area under the curve was 0.757 (P = 0.001) and the optimal cut-off value of serum TK1 concentration level was 1.75 pM, with a 87.8% specificity, a 63.6% sensitivity. It was showed that serum TK1 concentration could be a predictive marker of IGHV mutational status, and might be applied for the assessment of prognosis in patients with CLL.
慢性淋巴细胞白血病（CLL）表现出显著的异质性，一些患者的寿命几乎正常，而另一些患者尽管接受了强化治疗，但在诊断后仅存活数月。本研究的目的是调查中国CLL患者血清胸苷激酶1（TK1）浓度及其与其他已确立的预后因素的相关性。采用增强化学发光斑点印迹法检测80例CLL患者的血清TK1浓度。与Binet A组患者相比，Binet C组患者（P = 0.002）、血清乳酸脱氢酶（LDH）水平较高（P = 0.012）和β2-微球蛋白（β2-MG）水平较高（P = 0.025）、IGHV未突变状态（P < 0.001）或ZAP-70（P = 0.014）和CD38（P = 0.018）表达水平较高的患者，其TK1浓度显著升高，而血清LDH和β2-MG水平较低、IGHV突变状态、或ZAP-70和CD38表达水平较低的患者则相反。观察到TK1水平与IGHV突变（r = 0.412，P < 0.001）或ZAP-70（r = 0.263，P = 0.024）有很强的相关性。根据血清TK1浓度和IGHV突变状态的受试者工作特征曲线分析，曲线下面积为0.757（P = 0.001），血清TK1浓度水平的最佳截断值为1.75 pM，特异性为87.8%，敏感性为63.6%。结果表明，血清TK1浓度可能是IGHV突变状态的预测标志物，并可能用于评估CLL患者的预后。
