Niguarda Cà Granda Hospital, Division of Hematology, Milan, Italy.
Cancer Biomark. 2010;6(1):1-9. doi: 10.3233/CBM-2009-0114.
New prognostic factors such as IgVh mutational status, ZAP-70 protein expression and cytogenetic abnormalities have shown to offer important prognostic information for patients with chronic lymphocytic leukemia (CLL). Our aim was to evaluate the optimal cut-off for IgVh mutational status, ZAP-70 expression and cytogenetic abnormalities in association with disease progression defined as the need for treatment within 3~years from diagnosis in 170 patients with B-CLL.
Receiver operating characteristics (ROC) analysis and multivariate general linear models (GLMs) were used to investigate the most significant cut-off values of these biomarkers and their prognostic impact.
Our findings estimated that the optimal cut-off for IgVh mutation status and for ZAP-70 protein expression was 97% and 16.5% respectively and a high concordance between the two was demonstrated. We identified 30% as being the best-cut-off for 17p-, 11q- and 6q-. In univariate analysis 17p- was found to be a significant predictor of the event only for the whole population. Multivariate analysis including all biological parameters, identified 11q deletion as the only significant regressor.
We assessed that IgVh mutational status, ZAP-70 protein and 6q- are powerful prognostic markers. Analyses of all these factors revealed that 11q deletion was the strongest predictor of disease progression in B-CLL.
新的预后因素，如 IgVh 突变状态、ZAP-70 蛋白表达和细胞遗传学异常，已经为慢性淋巴细胞白血病（CLL）患者提供了重要的预后信息。我们的目的是评估 IgVh 突变状态、ZAP-70 表达和细胞遗传学异常在 170 例 B-CLL 患者中与 3 年内需要治疗的疾病进展（定义为诊断后）相关的最佳截断值。
采用受试者工作特征（ROC）分析和多变量广义线性模型（GLMs）来研究这些生物标志物的最佳截断值及其预后意义。
我们的研究结果估计，IgVh 突变状态和 ZAP-70 蛋白表达的最佳截断值分别为 97%和 16.5%，并且这两种方法之间具有高度一致性。我们发现 30%是 17p-、11q-和 6q-的最佳截断值。在单变量分析中，17p-仅在全人群中是疾病事件的显著预测因子。包括所有生物学参数的多变量分析表明，11q 缺失是 B-CLL 疾病进展的唯一显著回归因子。
我们评估了 IgVh 突变状态、ZAP-70 蛋白和 6q-是强大的预后标志物。对所有这些因素的分析表明，11q 缺失是 B-CLL 疾病进展的最强预测因子。
