急性早幼粒细胞白血病中CD117和CD34共表达的临床意义

目的：研究CD117和CD34在成人急性非淋巴细胞自血病（Acute nonlymphoblastic leukemia，ANLL）M1～M2型和急性早幼粒细胞白血病（Acute promyelocytic leukemia，arE）M3患者中的表达，重点探讨M3患者CD117和CD34共表达（CD117／CD34共表达）的临床意义。方法：将研究病例分为M1～M2和M3二组，采用流式细胞术（Flow cytometery，FCM）随机检测54例M3和63例M1～M2二组初诊患者骨髓单个核细胞（BMMNC）髓系抗原CD117和干（祖）细胞抗原CD34的表达；比较M1～M2和M3二组ANLL患者中CD117、CD34表达的阳性率的差异，以及CD13、CD33和CD117分别与CD34共表达的阳性率差异。结果：CD117在M1～M2组患者中表达的阳性率是71．4／％（45／63），在M3组表达的阳性率为66．7％（36／54），差异无统计学意义（P=0．58）；CD34在M1～M2和M3二组中表达的阳性率分别为66．7％（42／63）和11．1％（6／54），差异有统计学意义（P=0．000）；二组ANLL的CD117／CD34共表达阳性率分别为71．1％（45／63）和7．4％（4／54），其差异有统计学意义（P=0．000）。结论：CD117可作为AL的髓系免疫学标志，但其在ANLL中的表达缺乏系列内阶段特异性。M3患者的CD34表达和CD117／CD34共表达的阳性率低于M1～M2者；CD117／CD34共表达可作为M1～M2和M3鉴别诊断的免疫学分型参考指标。     

CD80，CD86和ICAM-1在急性白血病细胞上的表达及意义

目的通过流式细胞术检测初诊患者急性自血病细胞上共刺激分子CD80、CD86以及黏附分子ICAM．1的表达，以了解其表达规律。方法通过流式细胞仪检测60例初治急性白血患者白血病细胞上CD80、CD86和ICAM-1的表达率；男37例，女23例，年龄2～85岁，中位年龄28岁；其中ALL20例，AML40例（M16例、M27例、M37例、M415例、M55例）。结果ALL组中的CD86的表达为（32．880±6．665）％，显著高于正常对照（P〈0．01），而CD80与正常BM对照比较无统计学意义；CD80、CD86在AML（M1、M2和M3）细胞上的表达分别为（0．766±0．187）％、（27．210±7．581）％，均显著高于相应的正常骨髓对照（P〈0．01）；在AML（M4和M5）细胞上CD80、CD86的表达与正常对照比较均无统计学意义。ICAM-1在ALL组中的表达与正常BM对照比较无统计学意义；在AML（M1、M2和M3）细胞上（63．820±7．484）％，显著高于相应的正常骨髓对照（P〈0．01）：而AML（M4和M5）细胞上表达为（50．590±7．092）％，显著低于相应的正常骨髓对照（P〈0．01）。结论CD80、CD86和ICAM．1在初治ALL和AML白血病细胞上的表达呈一定变异性，CD86在ALL上呈高表达，CD80、CD86和ICAM-1在AML（M1、M2和M3）上均呈高表达，而ICAM-1在AML（M4和M5）上均呈低表达。     

急性髓系白血病中CD64表达的敏感性及特异性研究

研究急性髓系白血病(AML)免疫分型中CD64的敏感性和特异性.用系列抗原对132例AML患者的骨髓细胞进行直接标记,并用流式细胞术进行分析.结果表明:在AML中,CD64对急性粒-单细胞白血病(M4)和急性单核细胞白血病(M5)中敏感性最高(分别为96.4%和100%),在其他AML(M0、M1、M2、M3,M6、M7)中表达均较低.CD64对M4和M5中的特异性为56.5%.因此,CD64有助于AML中M4、M5的鉴别诊断.     

CD117在急性白血病中的表达及临床意义

目的探讨CD117在急性白血病中的表达及其临床意义。方法应用CD45/SSC设门,直接荧光标记法,经流式细胞术对73例急性髓系白血病（AML）和47例急性淋巴细胞白血病（ALL）进行CD117的检测。结果对照组、ALL及AML3组CD117的表达阳性率差异有统计学意义（χ2=41.681,P﹤0.01）。AML组CD117的表达阳性率（58.9%）明显高于对照组（0）及ALL组（8.5%）。CD117/CD34的共表达率ALL组明显低于AML组（4.3%vs45.2%,P﹤0.05）。AML组CD117＋患者的CR率为60.5%,CD117-患者为76.7%,两者比较差异无统计学意义（P〉0.05）;而CD117＋/CD34＋患者的CR率为54.5%,明显低于CD117-/CD34-患者的CR率（88.2%,P﹤0.05）。结论 CD117可作为辅助诊断AML的髓系标志抗原,CD34＋/CD117＋可作为进一步排除ALL的指标。CD117＋/CD34＋可能是AML中一类预后不良的特殊亚型,可以作为AML预后判断的指标之一。     

CD64在急性白血病免疫分型中的意义

目的探讨CD64在急性白血病免疫分型中的意义。方法应用直接荧光标记法,经流式细胞术对116例急性髓系白血病(AML)和70例急性淋巴细胞白血病(ALL)进行免疫表型的检测。结果 AML组CD64的表达阳性率明显高于ALL组(41.4%vs 2.9%,P<0.01)。CD64在M5和M4的表达阳性率最高,分别为77.1%和55.6%。CD64的阳性表达率在M0(0)、M1(0)、M2(7.9%)明显低于M3(47.1%)、M4与M5(P<0.01)。各亚型CD64阳性病例中,M4、M5的CD64阳性细胞表达率分别为(62.5±24.7)%、(68.7±25.9)%,均明显高于M2(28.3%±5.7%)、M3(34.3%±6.3%)(P<0.01)。CD64对诊断AML的灵敏度优于CD14,其特异度优于CD117、CD33及CD13。虽然CD64诊断M4\M5的特异度较CD14稍差(82.5%vs 100%),但是灵敏度高于CD14(69.8%vs 41.5%)。结论 CD64可作为辅助诊断AML的髓系标志抗原,有助于提高M4/M5的检出率及其与其他AML亚型的鉴别诊断。     

获得性21三体髓系恶性血液病的生物学特征及预后意义

目的：系统分析21三体髓系恶性血液病临床特征及预后意义。方法：应用常规细胞遗传学技术对536例急性髓系白血病（AML）、145例骨髓增生异常综合征（MDS）进行检测，随访疗效及生存状况。结果：18例21三体患者在AML和MDS的发病率分别为1．68％和6．21％。作为孤立异常分别为0．18％及2．74％。伴有结核病、银屑病及毒物接触史患者（38．89％）比非21三体患者（8．45％）显著增多（P＜0．01）。AML以M2a多见。MDS转白血病均为M4a。55．56％AML获得完全缓解，中位生存期10个月。5例M2a型中位生存期仅为3个月，与染色体核型正常患者相比显著缩短（P＜0．05）。结论：原发或孤立出现的21三体AML通常与M2a型相关，且多有其他疾病史或毒物接触史，预后极差。MDS转白类型常为M4a，预后不良。     

新疆乌鲁木齐地区142例急性白血病流式细胞术免疫分型研究

目的:研究新疆乌鲁木齐地区急性白血病(AL)患者免疫表型特征及分布特点。方法:选用细胞表面分子CD20、CD14、CD3、CD2、CD33、HLA-DR、CD15、CD10、CD5、CD22、CD7、CD13、CD34、CD11b、CD19、CD117等的单克隆抗体,采用流式细胞仪CD45/SSC双参数散点图设门法对142例AL患者进行免疫表型分析。结果:35例急性淋巴细胞白血病(ALL),其中6例伴有髓系抗原的表达(14.3%)且表达最频繁的为CD13;96例急性髓系白血病(AML),其中21例伴有淋系抗原的表达(21.9%)且表达最频繁的为CD7;11例为FAB难以分类的急性白血病(UAL),兼有淋系和髓系抗原的表达。ALL免疫分型特点在新疆汉族和维吾尔族(简称维族)中差异无统计学意义(P>0.05),在AML中,汉族髓系抗原的表达率依次为CD13>CD33>CD15,维族髓系抗原的表达率依次为CD13>CD15>CD14,且维族患者多伴有淋系抗原CD7的表达。结论:FCM免疫分型是在细胞形态学和细胞染色基础上对AL诊断与分型的重要补充,免疫表型的检测对AL的诊断和治疗有重要意义。     

急性髓系白血病177例免疫分型特点及预后分析

目的:探讨急性髓系白血病(AML)患者免疫分型的特点及临床意义.方法:采用CD45/SSC双参数散点图设门方法对177例急性髓系白血病患者进行三或四色流式细胞术免疫分型分析.结果:177例AML显示,CD33,CD38,CD117,CD13及HLA-DR高度表达,阳性率分别为92.66%,81.36%,75.14%,68.93%和67.80%.40.7%的AML患者伴有淋系抗原表达,最常见的是CD7(22.6%),其次是CD19(7.91%).结论:多色流式细胞仪术免疫分型对AML的诊断及预后具有重要意义.     

白血病相关免疫表型与难治性急性髓细胞白血病的关系

分析白血病相关免疫表型（LAIP）与难治性急性髓细胞白血病（AML）的关系。回顾性分析45例经两个疗程化疗未缓解的难治性白血病患者在发病时经多色流式细胞术检测的免疫表型结果,分析其抗原跨阶段表达（CD34/CD11b、CD34/CD14、CD34/CD15）和抗原跨系列表达（CD7/CD13、CD19/CD13、CD56/CD13）,以54例经两个疗程化疗达到完全缓解（CR）的患者为对照。结果显示,白血病细胞CD34与CD11b共表达在难治组AML表达率为37.8%,而非难治组为13.0%（P=0.004）,其它抗原跨阶段表达（CD34/CD14、CD34/CD15）及抗原跨系列表达（CD7/CD13、CD19/CD13、CD56/CD13）在两组病例中无显著差异（P〉0.05）。结论：CD34/CD11b共表达与难治性AML相关。对这类患者可加大化疗剂量或考虑骨髓移植,以提高患者的长期生存率。     

成人急性髓性白血病细胞CD表型与预后的关系

分析成人急性髓细胞性白血病(AML)初诊免疫表型与完全缓解(CR)率及缓解期的关系。采用直接免疫荧光标记单克隆抗体(McAb)及流式细胞仪(FCM)检测骨髓白血病细胞免疫表型。显示在AML中各髓系抗原的表达率依次为CD13>CD33>CD45>CD38>CD11b>CD117>CD14;干/祖细胞分化抗原CD34表达率为46%,以M2和M4为最高(63%和66%);M3几乎不表达CD34和HLA-DR;淋系抗原在部分AML中表达阳性;CD117+病例较阴性组具有明显低CR率和短CR期。提示免疫表型的相关研究将提高AML诊断准确性,并将有助于指导AML治疗和判断其预后。     

Light scatter characteristics of blast cells in acute myeloid leukaemia: association with morphology and immunophenotype.

AIMS--To analyse the forward scatter/side scatter (FSC/SSC) distribution of acute myeloblastic leukaemia (AML) blast cells in order to assess whether it correlates with their morphology, immunophenotype, and clinical and biological disease characteristics. METHODS--FSC/SSC patterns were established upon taking into account the localisation of the residual T lymphocytes in the FSC/SSC dot plot as an internal biological standard. One hundred and seventy one newly diagnosed AML patients were analysed and five different FSC/SSC patterns were established. These five patterns could be grouped into two major categories taking into account the FSC/SSC distribution of normal cells in a bone marrow aspirate: immature patterns (1 and 2) and mature patterns (3, 4, and 5). These FSC/SSC patterns were correlated with different clinical and biological characteristics of AML patients. RESULTS--No significant associations were detected in relation to the clinical and haematological disease characteristics and the prognosis of these patients. By contrast there was a significant correlation between the FSC/SSC pattern of the AML blast cells and the FAB classification. An increased reactivity for the antigens associated with myeloid differentiation such as CD13, CD33, CD11b, CD15, CD14, CD4, CD56, and/or CD16 was detected among cases showing a mature FSC/SSC pattern (3, 4, and 5), both in the whole series and even within each of the FAB AML subtypes. By contrast, the reactivity for the CD34 precursor cell associated antigen was higher among those cases displaying an immature FSC/SSC pattern, this being observed even within each FAB subgroup. CONCLUSIONS--The FSC/SSC pattern distribution of AML blast cells not only provides an additional objective and reproductible system for the classification of these leukaemias but it may also represent a connection between the FAB morphological groups and the immunophenotypic classification of AML patients.     

Immunophenotypic profile of adult acute myeloid leukemia (AML): analysis of 267 cases in Thailand

Little data exists in Thailand and other Southeast Asian countries regarding the biological characteristics of adult acute myeloid leukemia (AML). In this study, we performed a flow cytometric analysis of 267 Thai adult AML cases to delineate the pattern of leukemic cell surface antigens. Forty-eight cases (18%) were identified as acute promyelocytic leukemia (M3) and 219 cases as non-M3. The most frequent subtype of AML in Thailand was M1/M2 and the least frequent was M7. M3 immunophenotypes were characterized by their unique lack of expression of CD34 and HLA-DR as contrast to the high mean expression of 50% and 70%, respectively, in non-M3. Overall, 60% of cases expressed CD34. Aberrant lymphoid antigens were uniquely seen in specific subtypes of Thai AML, including CD19 (33% of non-M3 vs 23% of M3) and CD2 (12% of M3 vs 2% of non-M3). CD56 was frequently expressed in both M3 and non-M3 while CD16 appeared to be associated with M4/M5 (24% of cases) and CD7 with M1/M2 (21% of cases). Eighty-one percent of non-M3 expressed CD38 while only 53% of M3 did. We found that most Thai adult AML patients were on average 15-20 years younger than those of the West or Japan with only 25% of Thai cases over 60 years of age, although the immunophenotypes were not markedly different. Biological studies of acute leukemia in various countries should help to provide epidemiological clues that play a role in the pathogenesis of leukemia in different geographic regions of the world. Our study represents the largest series of AML ever investigated in the Southeast Asian region.     

CD79 alpha expression in acute myeloid leukemia. High frequency of expression in acute promyelocytic leukemia.

CD79 alpha is a subunit of an intracytoplasmic protein reported to be specific for B lymphocytes, including immature B lineage cells. To evaluate expression of the CD79 alpha antigen in acute myeloid leukemia (AML), we studied forty-eight cases of AML by paraffin section immunohistochemistry. The cases included four MO, nine M1, nine M2, ten M3, ten M4, and six M5 AMLs using criteria of the French-American-British cooperative group. Eleven cases demonstrated cytoplasmic staining for the CD79 alpha antigen, including one M1, nine M3, and one M5 AML. These CD79 alpha-positive cases represented 5% of all non-promyelocytic AMLs and 90% of all acute promyelocytic leukemias studied. All acute promyelocytic leukemias had the characteristic t(15;17)(q24;q21), including two cases of the microgranular variant (M3v). No other B-lineage-associated antigens were found in the CD79 alpha-positive cases, with the exception of a subpopulation of CD19-positive leukemic cells in one patient. The two non-promyelocytic leukemias that expressed CD79 alpha had no evidence of t(15;17) and did not express any additional B-lineage-associated antigens that might suggest a mixed lineage proliferation. This study demonstrates that CD79 alpha expression in acute leukemia is not restricted to B-lineage acute lymphoblastic leukemias and that CD79 alpha expression is frequently associated with t(15;17) acute myeloid leukemia.     

Functional expression of the CD163 scavenger receptor on acute myeloid leukemia cells of monocytic lineage

The hemoglobin-haptoglobin (Hb-Hp) scavenger receptor CD163 is a monocyte/macrophage-restricted surface antigen, whose expression is strongly up-regulated by glucocorticoids. We have previously shown that CD163 is expressed by acute myeloid leukemia (AML) cells of monocytic lineage. Herein, we expand this finding by demonstrating constitutive and glucocorticoid-enhanced CD163 expression on French-American-British M4/M5 AML cells, and leukemic blasts of other AML subtypes and normal hematopoietic progenitor cells do not express CD163. We provide evidence that the functional characteristics of CD163 are preserved on malignant cells by showing the capability of types M4/M5 blast cells to internalize Hb-Hp by a CD163-mediated mechanism. Together, our results identify CD163 as a potential target for therapeutic intervention. It is important that CD163 does not appear to be released from leukemic blasts under noninflammatory conditions, thus reducing the probability of off-target side-effects as a result of competitive binding of potential therapeutic ligands to nonmembrane-bound CD163.     

急性髓细胞白血病患者CD56抗原表达与MDR1基因表达量的关系研究

目的 研究初治急性髓细胞白血病(AML)患者CD56抗原表达与多药耐药(MDR)1基因表达量的关系,探讨CD56抗原表达与MDR1基因表达量在AML耐药中的作用及相互关系.方法 采用流式细胞术(FCM)和建立实时荧光定量PCR技术分别检测79例AML患者CD56抗原表达及MDR1基因表达水平并分析两者之间的关系及临床意义.结果 24.1%AML患者表达CD56抗原,FAB亚型中M5 AML患者表达阳性率高于其他亚型.遗传学危险度分级高危组患者CD56抗原表达阳性率显著高于中危组(P<0.01),伴t(8:21)AML患者CD56抗原表达阳性率(57.1%)显著高于其他低危组AML(P<0.05).CD56抗原表达阳性初治AML患者MDR1基因表达水平显著高于表达阴性患者(P<0.001).MDR1基因高表达且CD56抗原阳性AML组的CR率(58.8%)显著低于MDR1基因低表达且CD56表达阴性组(89.2%,P<0.01).结论 AML患者CD56抗原表达与MDR1基因表达水平存在相关性;同时定量检测MDR1基因表达及CD56抗原表达更有助于判断预后.     

Myeloperoxidase gene expression in acute leukemias

Since myeloperoxidase (MPO) is considered to be a critical marker of differentiating acute myelogenous leukemia (AML) from acute lymphocytic leukemia (ALL), the analysis of MPO gene expression may provide further insight into the leukemia classification and the lineage fidelity of leukemia cells. By Northern blot hybridization using full-length MPO cDNA as a probe, approximately 66% of AML cells (3/4 M1 cases, 2/4 M2 cases, 15/15 M3 cases, 11/15 M4 cases, and 2/12 M5 cases) were found to express MPO mRNAs, whereas none of 18 ALL cases did. MPO mRNA was detectable when AML cells contained at least 10% peroxidase-positive cells. APL (M3) cells expressed high levels of mRNA in accordance with heavy staining for peroxidase.     

Immunophenotypic, cytogenetic and clinical features of 192 AML patients in China

Immunophenotypic characterization of the leukemic cells has been widely used as a tool for diagnosis, classification and prognosis of leukaemia. A total of 192 Chinese patients with acute myeloid leukemia (AML) were immunophenotyped by flow cytometry using a panel of monoclonal antibodies. Among the 192 patients enrolled in this study, 125 cases were also subjected to karyotype analysis by G-banding technology. We found that CD33, CD13, MPO and CD117 were the most commonly expressed antigens in AML. A combination of intensive autofluorescence, both CD34⁻ and HLA-DR⁻, and high expression of CD13, CD33 and MPO had significant value for M3 diagnosis. CD14 was expressed only in M4 and M5, and both intensive positivity of CD64 and CD15 with high expression of HLA-DR may suggest great possibility for diagnosis of M5. Lymphoid markers expression was documented in 47.9% of the 192 AML cases analyzed. CD56 (26.0%) and CD7 (20.8%) were the most commonly expressed lymphoid markers in AML patients. Abnormal karyotypes were detected in 76 out of 125 (60.8%). Higher CD34 positivity was found in LymAg⁺ group (77.2%) than in LymAg⁻ group (48.0%). Our results indicate that immunophenotype analysis was useful for AML diagnosis and classification and the immunophenotype did have relevance to the abnormal cytogenetic changes and clinical features in AML.