112例成人急性白血病免疫分型

目的 探讨成人急性白血病（AL）免疫分型标准及其意义，了解成人AL抗原表达规律和免疫亚型分布情况。方法 细胞膜抗原采用单克隆抗体双色直接免疫荧光标记法，胞浆内抗原采用单色直接免疫荧光标记法及流式细胞术，分型标准试用抗体积分系统。结果 （1）未分化型占0.9%；单纯型占51.8%，其中急性髓系白血病（AML）占34.8%，B淋巴细胞白血病（B-ALL）占13.4%,T淋巴细胞白血病（T-ALL）占3.6%；变异型占38.4%，其中髓系占27.7%，淋巴细胞系占10.7%；混合型占8.9%。（2）AL患者CD34阳性占50%，M3患者HLA-DR均为阴性，AML变异型伴CD7阳性最常见，然后依次为CD10阳性，CD19阳性、CD20阳性，B-ALL变异型依次为CD13阳性，CD33阳性，CD7阳性，T-ALL变异型依次为CD33阳性，CD10阳性，CD19阳性，混合型以B淋巴细胞和随细胞系共同表达最多（70%），其次为T、B、髓细胞系共表达（20%）及T细胞系和髓细胞系共表达（10%）。结论 本方法直接准确地反映成人AL免疫分型特点，特别是采用数字化分型指标。简洁、客观、易于掌握。

Immunological classification of 112 adult acute leukemia patients

OBJECTIVE: To explore the criteria and significance of immunological classification in adult acute leukemias. METHODS: One or two color monoclonal antibodies directly labeled with immunofluorescence were used to analyse the surface and cytoplasma antigens by flow cytometry, and an antibody integral system was developed for the immunologic classification. RESULTS: One hundred and twelve adult acute leukemia cases were detected. (1) The undifferentiated phenotype account for 0.9%, simple 51.8%, variant 38.4% and mixed lineage 8.9%. (2) The abnormal expressions of antigen in variant and mixed lineage phenotype were CD7, CD33, CD10, CD13, CD19 and CD20, by order of decreased level. CONCLUSION: The strict, numerical diagnostic criteria was very convenient and useful for immunophenotyping of adult acute leukemia.