Gaikwad Amos S, Donohue Rachel E, Elghetany M Tarek, Sheehan Andrea M, Lu Xinyan Y, Gramatges Maria M, McClain Kenneth L, Mistretta Toni-Ann, Punia Jyotinder N, Moore Timothy J, Goltsova Tatiana, Cubbage Michael, Curry Choladda V
Texas Children's Cancer and Hematology Centers Houston, Texas ; Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine Houston, Texas.
Department of Pathology and Genomic Medicine, Houston Methodist Hospital Houston, Texas.
Int J Clin Exp Pathol. 2014 Aug 15;7(9):6225-30. eCollection 2014.
Precursor B acute lymphoblastic leukemia (B-ALL) is the most common cancer in children and overall, has an excellent prognosis. However, the Philadelphia chromosome translocation (Ph+), t(9;22)(q34;q11), is present in a small subset of patients and confers poor outcomes. CD25 (IL-2 receptor alpha chain) expression has been associated with Ph+ B-ALL in adults, but no similar study has been performed in pediatric B-ALL.
A retrospective analysis of 221 consecutive pediatric patients with a diagnosis of B-ALL (blood and/or bone marrow) from 2009 to 2012 was performed to determine an association between Ph+ B-ALL and CD25 expression. A threshold of 25% was used to define positive cases for CD25 expression by flow cytometry.
There were 221 patients with a diagnosis of B-ALL ranging from 2 to 22 years (median, 6 years). Eight (3.6%) B-ALL patients were positive for the Philadelphia chromosome translocation (Ph+ B-ALL) and 213 were negative (Ph-negative B-ALL). CD25 expression was observed in 6 of 8 (75%) Ph+ B-ALL patients and 6 of 213 (2.8%) Ph-negative B-ALL patients. CD25 expression was significantly higher in Ph+ B-ALL compared to Ph-negative B-ALL, with median CD25 expression of 64% (range 0-93%) and 0.1% (range 0-91%), respectively (P ≤ 0.0002). Therefore, CD25 expression as a predictor of Ph+ B-ALL had 75% sensitivity, 97% specificity, 50% positive predictive value and 99% negative predictive value.
CD25 expression is a specific and relatively sensitive marker for the identification of Ph+ B-ALL in the pediatric population.
前体B淋巴细胞白血病（B-ALL）是儿童中最常见的癌症，总体预后良好。然而，费城染色体易位（Ph+），t(9;22)(q34;q11)，存在于一小部分患者中，预后较差。CD25（白细胞介素-2受体α链）表达与成人Ph+ B-ALL相关，但尚未在儿童B-ALL中进行类似研究。
对2009年至2012年连续诊断为B-ALL（血液和/或骨髓）的221例儿科患者进行回顾性分析，以确定Ph+ B-ALL与CD25表达之间的关联。采用25%的阈值通过流式细胞术定义CD25表达阳性病例。
有221例诊断为B-ALL的患者，年龄在2至22岁之间（中位数为6岁）。8例（3.6%）B-ALL患者费城染色体易位呈阳性（Ph+ B-ALL），213例为阴性（Ph阴性B-ALL）。8例Ph+ B-ALL患者中有6例（75%）观察到CD25表达，213例Ph阴性B-ALL患者中有6例（2.8%）观察到CD25表达。与Ph阴性B-ALL相比，Ph+ B-ALL中CD25表达显著更高，CD25表达中位数分别为64%（范围0-93%）和0.1%（范围0-91%）（P≤0.0002）。因此，CD25表达作为Ph+ B-ALL的预测指标，敏感性为75%，特异性为97%，阳性预测值为50%，阴性预测值为99%。
CD25表达是儿科人群中识别Ph+ B-ALL的特异性且相对敏感的标志物。
