Yu Zhen, Li Zeng-jun, Yi Shu-hua, Zhou Ke-shu, Hao Mu, Li Chang-hong, Qi Jun-yuan, Qiu Lu-gui
Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences, Tianjin, China.
Zhonghua Yi Xue Za Zhi. 2011 Dec 13;91(46):3267-70.
To investigate the expression pattern of stereotyped B-cell receptor (BCR) and its prognostic significance in Chinese chronic lymphocytic leukemia (CLL) patients and evaluate the relationship to other prognostic markers.
Multiplex polymerase chain reaction (PCR) was used to identify the immunoglobulin variable heavy-chain (IGHV) segment and its mutation status in 116 CLL patients from April 1992 to April 2010. For CDR3-driven clustering, all in-frame IGHV-D-J rearrangements were aligned by the multiple sequence alignment software ClustalW2.
There were 102 of 116 samples from newly diagnosed CLL were successfully analyzed. IGHV CDR3 genes were identified in 73/102 cases. Fourteen patients (19.2%) carried stereotyped BCR. A high percentage of carried stereotyped BCR was observed in IGHV non-mutated group versus mutated group (40.9% vs 11.8%, P = 0.005). Patients with stereotyped BCR had a higher frequency of deletion (17q) (33.3% vs 10.7%, P = 0.045). The median progression-free survival (PFS) in patients with stereotyped BCR was much shorter than other patients (39 vs 84 months, P = 0.002).
The patients with stereotyped BCR have a poor prognosis. It highlights the importance of immunoglobulin mediated stimulation in the development of CLL.
研究中国慢性淋巴细胞白血病（CLL）患者中定型B细胞受体（BCR）的表达模式及其预后意义，并评估其与其他预后标志物的关系。
采用多重聚合酶链反应（PCR）鉴定1992年4月至2010年4月期间116例CLL患者的免疫球蛋白可变重链（IGHV）区段及其突变状态。对于CDR3驱动的聚类，所有符合读框的IGHV-D-J重排均通过多重序列比对软件ClustalW2进行比对。
116例新诊断CLL患者中有102例样本成功分析。在102例中的73例中鉴定出IGHV CDR3基因。14例患者（19.2%）携带定型BCR。在IGHV未突变组中携带定型BCR的比例高于突变组（40.9%对11.8%，P = 0.005）。携带定型BCR的患者缺失（17q）频率更高（33.3%对10.7%，P = 0.045）。携带定型BCR患者的无进展生存期（PFS）中位数明显短于其他患者（39对84个月，P = 0.002）。
携带定型BCR的患者预后较差。这突出了免疫球蛋白介导的刺激在CLL发生发展中的重要性。
