The lower expression of CD20 antigen molecules on the B cell membrane is the primary characteristic of B-chronic lymphocytic leukemia (B-CLL). In this paper, we combined laser scanning confocal microscopy (LSCM) and quantum dots labeling to detect the expression and distribution of CD20 molecules on CD20+B lymphocyte surface. Simultaneously, we investigated the morphology and ultrastructure of the B lymphocytes that belonged to the normal persons and B-CLL patients through utilizing the atomic force microscope (AFM). In addition, we measured the force spectroscopy of CD20 antigen-antibody binding using the AFM tips modified with CD20 antibody. The fluorescent images indicated that the density of CD20 of normal CD20+B lymphocytes was much higher than that ofB-CLL CD20+B cells. The AFM data show that ultrastructure of B-CLL CD20+B lymphocytes became more complicated. Moreover, the single molecular force spectroscopy data show that the special force of CD20 antigen-antibody was four times bigger than the nonspecific force between the naked AFM tip and cell surface. The force map showed that CD20 molecules distributed homogeneously on the normal CD20+B lymphocytes, whereas, the CD20 molecules distributed heterogenous on B-CLL CD20+B lymphocytes. Our data provide visualized evidence for the phenomenon of low-response to rituximab therapy on clinical. Meanwhile, AFM is possible to be a powerful tool for development and screening of drugs for pharmacology use.%CD20抗原分子在B细胞上表达下降是慢性B淋巴细胞白血病(B-CLL)的标志性特征.采用激光扫描共聚焦显微镜(LSCM)和量子点标记相结合的方法对正常和B-CLL外周血CD20+B淋巴细胞膜表面CD20抗原分子的表达及分布进行了荧光成像.同时,采用原子力显微镜(AFM)对CD20+B细胞的形貌及超微结构特征进行了表征,并且将AFM针尖用生物素化的单克隆抗体进行修饰,对CD20+B细胞表面的CD20杭原-抗体之间的单分子力谱进行了探测.LSCM荧光图像显示,B-CLL CD20+B淋巴细胞上CD20分子的表达量比正常CD20+B淋巴细胞显著降低.AFM结果显示,B-CLL CD20+B淋巴细胞超微结构比正常的粗糙.力谱结果显示,CD20抗原-杭体的相互作用力大约是非特异性黏附力的5倍,CD20分子在正常CD20～+B淋巴细胞膜上分布比较均匀,小部分有聚集现象,反之,在B-CLL CD20+B淋巴细胞膜表面分布稀疏.利用以上两种方法能进一步观察到B-CLL外周血B淋巴细胞的异常,并在一定程度上解释临床上B-CLL病人对利妥昔的低反应现象,为针对抗原CD20的治疗用药选择提供参考.
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