急性白血病的抗原表达及其临床意义

目的：探讨成人急性白血病（AL）的抗原表达及其临床意义。方法：采用直接免疫荧光法标记，流式细胞仪检测分析69例AL的免疫表型，结果：（1）29例成人急性淋巴细胞白血病（ALL）髓系抗原阳性表达率为30％，其中CD13为20．7％，CD33为10．3％，T－ALL和B－AL 系抗表达无显著性差异（P＝0．367）；CD34表达阳性的ALL髓系抗原表达率明显高于CD34表达阴性的ALL髓系抗原表达率（77．8％vs13.3%,P=0.036);ALL髓系抗原阳性表达的CR率明显低于髓系抗原阴性表达的CR率（33．3%vs80%,P=0.0203);(2)40例急性髓性白血病（AML）淋系抗原表达率为30％，其中CD7为15％，CD19为12．5％，CD2为2．5％，CD7主要分布在M1，M2亚型中，CD34阳性AML的淋系抗原表达率明显高于CD34阴性AML的淋系抗原表达率（61．1％vs4.5%,P=0.000125);AML淋系抗原阳性表达的CR率低于淋系抗原阴性表达的CR率，但差异无显著性（50％vs 71.4%,P=0.126)，结论：成人AL的抗原错译表达率约为30％，CD34阳性AL的抗原错译表达率明显高于CD34阴性AL的抗原错译表达率，有抗原错译表达的AL的CR率低于无抗原错译表达的AL和CR率。

Immunophenotype of acute leukemia and its clinical significance]

OBJECTIVE: To examine the immunophenotype of adult acute leukemia and analyze its clinical significance. METHODS: Immunophenotypes were examined by direct immunofluorescence method and flowcytometry in 69 de novo AL. RESULTS: 1. The incidence of myeloid antigen expression in 29 adult ALL was 30%. Among them, CD13 was 10.3% and CD33 was 20.7%, no difference was found in expression of myeloid antigens between B-ALL and T-ALL (P > 0.05). Myeloid antigens were expressed much more higher in CD34 positive ALL than in CD34 negative ALL (77.8% vs 13.3%, P = 0.036). CR rate in myeloid antigen positive ALL was lower than in myeloid antigen negative ALL (33.3% vs 80%, P = 0.0203). 2. The incidence of lymphoid antigen expression in 40 adult AML was 30%. Among them, CD7 was 15%, CD19 12.5% and CD2 2.5%. CD7 was mainly expressed in M1 and M2 subtypes. Lymphoid antigens were expressed higher in CD34 positive AML than in CD34 negative AML (61.1% vs 4.5%, P = 0.000125). Though CR rate was lower in lymphoid antigen positive AML than in lymphoid antigen negative AML, no significant difference between them was noted (50% vs 71.4%, P = 0.126). CONCLUSION: Aberrant antigen expression in adult acute leukemia is about 30%. Antigen aberrant is much higher in CD34 positive AL than in CD34 negative AL. The CR rate of antigen aberrant AL is lower than that of usual AL.