Laboratory of Oncology/Hematology and Transplantation, Institute of Biomedical Research, Barcelona, Spain.
Department of Hematology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Spain.
Cytometry B Clin Cytom. 2019 Mar;96(2):143-148. doi: 10.1002/cyto.b.21722. Epub 2018 Oct 16.
The diagnosis of CLL is supported by a typical morphology and immunophenotype and usually does not present difficulties. Nevertheless, some patients with CLL can show an atypical phenotype, this raising the possibility of a lymphoproliferative disorder other than CLL. It has been recently shown that the expression of CD200 could be a rather consistent marker for CLL.
The expression of CD200 was investigated in 120 consecutive patients with B-cell chronic lymphoproliferative disorders (B-CLPD) (65 cases diagnosed as typical CLL, 16 atypical CLL, and 39 non-CLL before entering the study) by using multiparametric flow cytometry with four color combinations. CD200 was analyzed as percentage of positive cells (≥30%) and MFIR expression. ROC curves were used to determine the cut-off for the CD200 MFIR. Matutes score (MS) was used as comparator.
All 81 (100%) patients classified as CLL and 25 of 39 (64.1%) classified as non-CLL expressed high CD200 expression (≥30%). CD200 expression showed a high sensitivity (100%) and a low specificity (35.9%), and the accuracy was similar to that of Matutes score markers (range: 79.2%-86.7%); except SmIg that was 59.1%. The addition of CD200 to the Matutes score correctly identified 74 of 81 (91.4%) CLL cases including 9 of 16 atypical CLL cases. As per non CLL cases, 37 of 39 (94.9%) were correctly diagnosed by the modified system. Altogether, CD200 improved the diagnostic accuracy of Matutes score from 86.7% to 92.5% (P < .01).
These results show that CD200 is a valuable, albeit not specific, CLL diagnostic marker. © 2018 International Clinical Cytometry Society.
CLL 的诊断依赖于典型的形态学和免疫表型，通常不会有困难。然而，一些 CLL 患者可能表现出非典型表型，这增加了除 CLL 以外的其他淋巴增殖性疾病的可能性。最近已经表明，CD200 的表达可能是 CLL 的一个相当一致的标志物。
采用四色组合的多参数流式细胞术，对 120 例连续的 B 细胞慢性淋巴增殖性疾病（B-CLPD）患者（诊断为典型 CLL 的 65 例，非典型 CLL 的 16 例，入组前非 CLL 的 39 例）进行 CD200 表达检测。分析 CD200 阳性细胞的比例（≥30%）和 MFIR 表达。使用 ROC 曲线确定 CD200 MFIR 的截断值。Matutes 评分（MS）作为比较器。
所有 81 例（100%）被归类为 CLL 的患者和 39 例（64.1%）被归类为非 CLL 的患者均表达高 CD200 表达（≥30%）。CD200 表达具有高灵敏度（100%）和低特异性（35.9%），准确性与 Matutes 评分标志物相似（范围：79.2%-86.7%）；除 SmIg 为 59.1%。将 CD200 添加到 Matutes 评分中，正确识别了 81 例 CLL 病例中的 74 例，包括 16 例非典型 CLL 病例中的 9 例。对于非 CLL 病例，改良系统正确诊断了 39 例中的 37 例。总的来说，CD200 将 Matutes 评分的诊断准确性从 86.7%提高到 92.5%（P<.01）。
这些结果表明 CD200 是一个有价值的、但非特异性的 CLL 诊断标志物。
