University College of Medical Sciences, Delhi, India.
Dr. Ram Manohar Lohia Hospital and PG Institute, New Delhi, India.
Indian J Pathol Microbiol. 2023 Apr-Jun;66(2):291-294. doi: 10.4103/IJPM.IJPM_1200_20.
Chronic lymphocytic leukemia (CLL) is prognosticated using the Rai and the Binet's staging. In the past few years, new parameters have been considered for prognostication. One such marker that has been a subject of speculation and found useful by some western studies is zeta-associated protein 70 (ZAP-70).
To investigate the prevalence of ZAP-70 and find out its association with other prognostic markers like Rai and Binet's stage and CD38 in Indian CLL patients.
Twenty-nine newly diagnosed cases of CLL were selected over 1 year. Immunophenotyping was done and expression of CD38 and ZAP-70 was evaluated on gated CLL cells.
Qualitative data were expressed as frequency and percentage. Differences between groups were evaluated using Student's t-test for quantitative data and Chi-square test/Fisher's exact t-test for qualitative variables. A P value less than 0.05 was considered significant.
We found a lower prevalence rate of ZAP-70 (2/29, 6.89%) with no association with any of the conventional poor prognostic factors. A large number of our CLL patients fall into the good prognostic group (22/29, ZAP 70-/CD38-) with a least number in the poor prognostic group (2/29, ZAP-70 + CD38+). Also, no association was found between ZAP-70 and CD38. The findings of the present study suggest that the majority of CLL patients in India have a good prognosis, may not require treatment, and have good overall survival. Geographical variations, genetic makeup, and natural history of the CLL could be the cause of such differences from western literature.
慢性淋巴细胞白血病（CLL）的预后采用 Rai 和 Binet 分期。在过去的几年中，已经考虑了一些新的参数来进行预后预测。其中一个被一些西方研究推测并认为有用的标志物是ζ相关蛋白 70（ZAP-70）。
研究 ZAP-70 的流行率，并探讨其与 Rai 和 Binet 分期以及 CD38 等其他预后标志物在印度 CLL 患者中的相关性。
在 1 年内选择了 29 例新诊断的 CLL 患者。进行免疫表型分析，并在门控 CLL 细胞上评估 CD38 和 ZAP-70 的表达。
定性数据表示为频率和百分比。使用 Student's t 检验比较组间的定量数据，使用卡方检验/Fisher 精确检验比较定性变量。P 值小于 0.05 被认为具有统计学意义。
我们发现 ZAP-70 的流行率较低（2/29，6.89%），与任何常规不良预后因素均无相关性。我们的大多数 CLL 患者属于良好预后组（22/29，ZAP 70-/CD38-），而不良预后组（2/29，ZAP-70 + CD38+）的患者数量最少。此外，ZAP-70 与 CD38 之间也没有发现相关性。本研究的结果表明，印度的大多数 CLL 患者具有良好的预后，可能不需要治疗，并且总体生存率较高。这种与西方文献的差异可能是由于地理位置、遗传构成和 CLL 的自然史的不同。
