成人Ph染色体阳性急性淋巴细胞白血病免疫表型特征分析

本研究旨在了解成人Ph染色体阳性（Ph^＋）的急性淋巴细胞白血病（ALL）免疫表型特征，并初步探讨其在预测疾病预后和指导临床治疗中的价值。应用多参数流式细胞仪（MFC）技术对35例Ph^＋ALL和59例Ph—ALL患者的标本（骨髓或外周血）进行细胞免疫表型检测，并分析其异常表达。结果显示：所有Ph^＋ALL均为B淋系表达；Ph^＋B—ALL患者CD34和CD13表达较Ph—B—ALL显著增高（P〈0．05），而CD38表达较Ph—B—ALL明显减低（p〈0．05）；两组患者伴髓系表达比例分别为85．7％和61．O％，Ph^＋B—ALL组显著增高（P〈0．05），表达的髓系抗原主要为CD13和／或CD33。结论：Ph^＋ALL存在较为特征性的免疫表型，在成人B—ALL中CD34、CD13和CD38的免疫表型分析有助于提示存在Ph染色体的可能，对于存在上述特征性免疫表型的成人ALL患者应进行bcr／abl融合基因检测。以上特征性免疫表型将有助于临床上对这组疾病进展迅速、预后差的亚型患者进行预测，并指导一临床个体化治疗。

Immunophenotypic Analysis of Philadelphia Chromosome Positive Acute Lymphoblastic Leukaemia in Adults

The aim of this study was to explore the immunophenotypic characteristics of Philadelphia chromosome positive （Ph ^＋） acute lymphoblastic leukaemia （ALL） in adults and to evaluate their significance in predicting prognosis and guiding clinical treatment of diseases. The cell immunophenotypes of leukemic marrow or blood samples from 35 cases of Ph^＋ ALL and 59 cases of Philadelphia chromosome negative （Ph-） ALL were detected by multiparameter flow cytometry, and their abnormal expressions were analysed. The results showed that the expression of all the Ph ＊ ALL cases was found in B-cell lineage. As compared with Ph - B-ALL cases, the Ph ^＋ B-ALL cases displayed the higher expression of CD34 and CD13 （p 〈0.05）, but lower expression of CD38 （p 〈0.05）. The ceoexpressed rates of CD13, CD33 and CD15 in cases of Ph ^＋ B-ALL and Ph - B-ALL were 85.7% and 61,0% respectively, The former was higher than the later （p 〈 0.05 ）. It is concluded that the Ph ^＋ ALL cases have the unique immunophenotype. The immunophenotypic analysis of CD34, CDI3 and CD38 in adult B-ALL cases contributes to judging the existence of Ph chromosome. Thereby for adult ALL patients having above-mentioned unique irnmunophenotypes, the detection of bcr/abl fusion gene must be performed. Such phenotypic profile is helpful for predicting the poor outcome of the disease, and for defining patients who require different treatment strategies.