Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Cancer Med. 2021 Jul;10(13):4387-4396. doi: 10.1002/cam4.3983. Epub 2021 Jun 1.
Moreau score has been used to differentiate chronic lymphocytic leukemia (CLL) from other mature B-cell neoplasms. However, it showed limitations in Asian patients. Therefore, we conducted a new score system replacing CD5 and CD23 with CD43 and CD180 to evaluate its diagnostic value of CLL. 237 untreated samples diagnosed with mature B-cell neoplasms were collected and were randomly divided into an exploratory and a validation cohort by a 2:1 ratio. The expression of CD5, CD19, CD20, CD23, CD43, CD79b, CD180, CD200, FMC7, and surface immunoglobulin (SmIg) were analyzed among all the samples. A proposed score was developed based on the logistic regression model. The sensitivity and specificity of the proposed score were calculated by ROC curves. CD43/CD180, CD200, FMC7, and CD79b were included in our new CLL score, which showed a sensitivity of 91.8% and a specificity of 83.1%. These results were confirmed in a validation cohort with a sensitivity of 90.5% (p = 0.808) and a specificity of 79.5% (p = 0.639). In CD5 negative or CD23 negative CLL group, the new CLL score displayed improved sensitivity of 79.4% compared to Moreau score and CLLflow score (41.2% and 47.1%, respectively). In atypical CLL group, the new CLL score showed improved sensitivity of 84.2% compared to Moreau score and CLLflow score (61.4% and 64.9%, respectively). This proposed atypical CLL score helped to offer an accurate differentiation of CLL from non-CLL together with morphological and molecular methods, particularly in Chinese patients with atypical immunophenotype.
莫罗评分曾被用于区分慢性淋巴细胞白血病（CLL）与其他成熟 B 细胞肿瘤。然而，其在亚洲患者中的应用受到限制。因此，我们构建了一个新的评分系统，用 CD43 和 CD180 取代 CD5 和 CD23，评估其对 CLL 的诊断价值。收集了 237 例未经治疗、诊断为成熟 B 细胞肿瘤的样本，按照 2:1 的比例随机分为探索性队列和验证性队列。分析了所有样本中 CD5、CD19、CD20、CD23、CD43、CD79b、CD180、CD200、FMC7 和表面免疫球蛋白（SmIg）的表达情况。基于逻辑回归模型构建了一个评分系统。通过 ROC 曲线计算了该评分系统的敏感性和特异性。纳入 CD43/CD180、CD200、FMC7 和 CD79b 的新 CLL 评分系统，其敏感性为 91.8%，特异性为 83.1%。在验证性队列中得到了验证，敏感性为 90.5%（p=0.808），特异性为 79.5%（p=0.639）。在 CD5 阴性或 CD23 阴性的 CLL 组中，新 CLL 评分的敏感性为 79.4%，优于莫罗评分（41.2%）和 CLLflow 评分（47.1%）。在不典型 CLL 组中，新 CLL 评分的敏感性为 84.2%，优于莫罗评分（61.4%）和 CLLflow 评分（64.9%）。该不典型 CLL 评分有助于与形态学和分子方法相结合，对 CLL 与非 CLL 进行准确区分，特别是在中国具有不典型免疫表型的患者中。
