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目的:探讨B细胞淋巴血液肿瘤患者血清中可溶性CD40(sCD40)水平及其临床意义。方法:79例B细胞恶性肿瘤患者,包括23例急性B淋巴细胞白血病(B-ALL)、24例多发性骨髓瘤(MM)、32例B细胞非霍奇金淋巴瘤(B-NHL),化疗前采用流式细胞仪检测B细胞肿瘤表面CD40的表达,化疗前后采用酶联免疫吸附试验(ELISA)检测血清sCD40表达水平,并与30例正常对照者进行对比分析。结果:3类肿瘤患者在成熟B细胞百分率、表达CD40的成熟B细胞百分率、表达CD40的成熟B细胞荧光强度间差异无统计学意义(P均>0.05)。B-NHL中未检测出幼稚B细胞,故将B-ALL与MM比较后发现,MM的浆细胞百分率、表达CD40的浆细胞百分率及浆细胞表达CD40的荧光强度与B-ALL的幼稚B细胞相应指标均有统计学差异。治疗后完全缓解的B-ALL、MM、B-NHL患者,其血清sCD40水平显著降低,与治疗前水平间差异有统计学意义(P均<0.05),在B-ALL和B-NHL患者中降低至对照组水平。治疗后非完全缓解的(部分缓解+未缓解)B-ALL、MM、B-NHL患者的血清sCD40水平与治疗前无统计学差异(P均>0.05),仍显著高于正常对照者。结论:CD40表达于成熟的B细胞表面,CD40可表达于B-ALL幼稚B细胞和MM浆细胞的表面,而血清sCD40水平可成为反映B-ALL、B-NHL、MM对治疗反应的参考指标。
Objective: To investigate the serum level of soluble CD40 (sCD40) in patients with B-cell lymphoma and its clinical significance. Methods: A total of 79 patients with B cell malignancies, including 23 patients with acute B lymphoblastic leukemia (B-ALL), 24 with multiple myeloma (MM) and 32 with B-cell non-Hodgkin’s lymphoma Before chemotherapy, the expression of CD40 on B cell tumor was detected by flow cytometry. The expression of sCD40 in serum was detected by enzyme linked immunosorbent assay (ELISA) before and after chemotherapy, and compared with 30 normal controls. Results: The percentages of mature B cells, percentage of mature B cells that expressed CD40, and that of mature B cells that expressed CD40 were not significantly different between the three groups (all P> 0.05). B-NHL was not detected in naive B cells, so B-ALL compared with MM found that MM plasma cell percentage, the percentage of plasma cells expressing CD40 and plasma cells expressing CD40 fluorescence intensity and B-ALL of naive B cells The corresponding indicators have statistical difference. Serum levels of sCD40 in B-ALL, MM and B-NHL patients with complete remission after treatment were significantly lower than those before treatment (all P <0.05). In patients with B-ALL and B-NHL Reduced to the control group level. The serum sCD40 levels of patients with incomplete remission (partial remission + non-remission) after treatment were significantly higher than those of the normal controls (all P> 0.05). CONCLUSIONS: CD40 is expressed on the surface of mature B cells. CD40 is expressed on the surface of B-ALL naive B cells and MM plasma cells. Serum sCD40 level may be a reference index reflecting the response to B-ALL, B-NHL and MM .