59例成人急性白血病流式细胞仪免疫表型结果分析

目的:探讨流式细胞仪免疫表型在急性白血病(AL)中的抗原表达规律及临床价值。方法:利用流式细胞仪进行四色免疫荧光标记术检测细胞免疫表型、骨髓细胞形态学分型对59例AL进行分析。结果:43例急性髓系白血病(AML)患者主要表达CD33,HLA-DR,CD13,MPO和CD117抗原,其中MPO和CD117抗原特异性高,同时还有18.64%的患者伴有淋系抗原(Ly+AML)CD7的表达,有10.16%的患者伴有淋系抗原(Ly+AML)CD19的表达;12例急性淋巴细胞白血病(ALL)患者主要表达CD79a,HLA-DR,CD19,CD20和CD10抗原,其中CD79a特异性和敏感性较高,同时有8.47%的ALL患者同时伴有髓系抗原CD13的表达;AML-M3多为CD34低表达,HLA-DR阴性;有4例形态学不能准确分型,需结合免疫表型分析才能确诊。结论:免疫分型与FAB同时结合互相补充,可提高AL的诊断分型准确率,有利于成人AL的诊断、治疗及预后判断,并能够确诊一些特殊类型的白血病。

The analysis on the flow cytometry immunity result for 51 adult cases with acute leukemia

Objective:To explore the clinical value of flow cytometry immunity result for acute leukemia(AL).Methods:The immunophenotypes and morphologic examination of bone marrow collected from 59 patients with AL were analyzed by four antibody combinations of multiparametric flow cytometry and cytochemistry staining,respectively.Results:Antigens including CD33,HLA-DR,CD13,MPO and CD117 were primarily expressed in 43 patients with acute myeloid leukemia(ALL),the specificity of MPO and CD117 was higher;CD7 was expressed in 18.64% patients(Ly+AML),and CD19 was expressed in 10.16% patients(Ly+AML).Antigens including CD79a,HLA-DR,CD19,CD20 and CD10 were primarily expressed in 12 patients with acute lymphocytic leukemia,the specificity and sensitivity of CD79a were higher;CD13 was expressed in 8.47% patients.CD34 was dimly expressed and HLA-DR was undetectable in patients with acute promyelocytic leukemia.4 patients were diagnosed by flow cytometer,which couldn′t accurately classified by morphologic examination.Conclusion:By combining immunophenotypes and morphologic examination of bone marrow,diagnostic accuracy of adult acute leukemia may be improved,was help to treat and predict prognosis of patients with acute myeloid Leukemia,and to define some special types of leukemia.