50例成人急性淋巴细胞白血病免疫表型分析

目的研究成人急性淋巴细胞白血病(ALL)的免疫表型特征,并分析免疫表型与细胞形态学及细胞遗传学的关系。方法应用一组系列相关单克隆抗体和CD45／SSC设门的三色流式细胞术对50例初治成人ALL进行免疫表型研究。结果 50 例ALL中42例B系来源,5例T系ALL,3例T／B混合型ALL。27例伴有髓系抗原表达(54％),髓系抗原主要表达CD13、CD33。大部分病例(90％)幼稚细胞均出现CD45的缺失及弱表达。细胞学形态学分析发现所分析病例中FAB-L1占多数(67％)、L2 27 ％。2例L3其免疫表型为B-祖细胞及成熟B细胞表型。20例存在染色体异常,其中6例染色体数目异常,涉及的异常为 8、-X、-7、-11、-4、、6和、13。染色体结构异常最多见为t(9;22),且均伴有髓系抗原的表达。结论 ALL免疫表型不是单独的诊断标准,其与细胞形态学及遗传学密切相关。

An Analysis of Immunophenotyping Characteristics in Fifty Adult Cases with Acute Lymphoblastic Leukemia

Objective To investigate the immunophenotypic characteristics in adult acute lymphoblastic leukemia (ALL), and its association with the cytomorphology and cytogenetics. Methods Immunophenotyping was performed in 50 adult patients with ALL by flow cytometry analysis using a panel of monoclonal antibodies and CD45/SSC gating. Results Among the 50 cases of ALL,42 were B lineage-ALL, 5 were T lineage-ALL and 5 were hybrid B-T phenotype. Myeloid antigen expression was identified in 27 of the cases, and the expressed myeloid antigens were mainly CD13 and CD33. Almost all of the cases were absent of CD45 antigen or with dim fluorescence intensity on blast cells in ALL.The majority of the cases was FAB L1 ALL.27% were L2 subtype. Three cases of L3 subtype had a pre-B and a mature B-cell immunophenotype. Twenty cases had cytogenetic abnormalities, and 6 with sole numerical aberrations including 8,-X,-7,-11,-4,-6 and -13. The most frequent structure abnormality was t (9;22) which all expressed myeloid-associated antigens. Conclusion Immunophenotypic data should not be used as a sole diagnostic criterion, and should be considered together with morphologic and cytogenetic characteristics.