120例白血病细胞免疫表型分析与形态学分析的比较

目的 比较细胞免疫表型分析和形态学分析在白血病诊断和分类中的意义。方法 采用BD公司急性白血病表型分析试剂盒,以流式细胞术对120例白血病患者细胞免疫表型进行分析,并与同期形态学分析结果比较。结果 白血病患者120例,形态学分析正确归类者80例,符合率为66．7％,免疫表型分析可准确对白血病进行诊断和分类。结论 形态学分析和免疫表型分析结合,是白血病诊断和分类的较佳途径。     

急性髓细胞白血病微分化型流式细胞术免疫分型分析

目的探讨流式细胞术（FCM）检测免疫表型在诊断急性髓细胞白血病微分化型（AML—M0）中的意义。方法采用多色FCM分析14例AML—M0病例的各相关抗原表达情况。结果14例AML—M0中,仅1例依据骨髓细胞形态学作出诊断,其余13例均依靠FCM作出明确诊断。在AML—M0中,髓系抗原CD33 14例（100％）表达阳性,CD13和CD117 9例（64％）表达阳性,CD34和HLA—DR12例（86％）表达阳性,一般成熟髓系相关抗原如CD16、CD10、CD14等均阴性,B和T淋巴细胞特异抗原如CD79a和CD3均为阴性,少数原始细胞表达细胞内髓过氧化物酶（MPO）、TdT。常常表达一些淋系但并不特异的抗原如CD7、CD2或CD19,但比淋巴细胞白血病表达的荧光强度弱。结论FCM免疫分型在AML—M0诊断中至关重要。     

Clinical,Histopathological, Immunophenotypic and Molecular Analysis of 60 Patients with Cutaneous T-cell Infiltrates with Follow up of Indeterminate Cases to Identify T-cell Lymphoma

Diagnosis of primary cutaneous T-cell lymphomas, especially of mycosis fungoides could be difficult in early stage due to clinical and histopathological similarity to reactive inflammatory dermatoses. To assess diagnostic value of complex histological, immunophenotypic and T-cell receptor gamma gene rearrangement analysis, skin biopsy specimen and peripheral blood samples of 60 patients with suspected cutaneous T-cell lymphoma were analyzed. Our results indicate clear distinction between reactive dermatoses (benign cases, n = 31) and cutaneous T-cell lymphomas (lymphoma cases, n = 17). As definite diagnosis was not obtained in a smaller group of patients (indeterminate cases, n = 12), these patients were followed up. Repeated skin biopsy confirmed mycosis fungoides in 6/12 cases, however in 6/12 patients the diagnosis remained indeterminate. We concluded that careful and complex clinical follow up and repeated histopathological, immunophenotypic and molecular analysis is needed for an appropriate diagnosis in the assessment of early stage mycosis fungoides and uncertain clinical cases.     

CD45设门多参数流式细胞术在急性白血病免疫表型分析中的应用

目的：分析急性白血病的抗原表达及其临床意义。方法：采用一组系列相关单抗直接免疫荧光标记CD45设门的多参数流式细胞术,检测35例急性白血病患者的免疫表型。结果：11例ALL中B－ALL8例,T－ALL3例,其中出现髓系抗原表达4例,占36．4％,CD34表达10例,占90．1％;24例AML中伴淋系抗原表达7例,占29．17％,CD34表达16例,占70．8％,DR的表达与CD34一致,5例M3患者均无CD34和HLA DR表达。伴髓系统原表达的ALL CR率低于髓系抗原阴性表达者（1／3及5／6）,但统计学上差异无显著性（P＞0．05）;伴淋系抗原表达的AML患者CR率明显低于淋系抗原阴性表达者（0／5及10／10）,两组间差异具有显著性（P＜0．01）。结论：CD45设门的多参数流式细胞术是分析白血病免疫表型的最好方法,白血病抗原的错义表达是预后不良的因素之一。     

急性髓细胞白血病M2＼t（8;21）型的免疫表型及临床特征

目的研究Ｍ２／ｔ（８；２１）的免疫表型及临床特征。方法用流式细胞仪（ＦＣＭ）或荧光显微镜（ＦＭ）间接免疫荧光法对３９例Ｍ２／ｔ（８；２１）及３８例不伴有ｔ（８；２１）易位的Ｍ２患者进行了免疫分型。诱导治疗主要采用ＨＡ（高三尖杉酯碱、阿糖胞苷）或ＤＡ（柔红霉素、阿糖胞苷）联合化疗方案。结果７９％的Ｍ２／ｔ（８；２１）表达ＣＤ３４，明显高于不伴ｔ（８；２１）的５０％（Ｐ＜０．０５）。２２例ＦＣＭ检测的Ｍ２／ｔ（８；２１）中１０例表达ＣＤ１９，而ＦＭ检测及不伴ｔ（８；２１）者均无ＣＤ１９表达。多药耐药相关的Ｐ┐糖蛋白在ｔ（８；２１）及不伴ｔ（８；２１）的Ｍ２患者中的阳性率分别为８％及３２％（Ｐ＜０．０５）。Ｍ２／ｔ（８；２１）患者的完全缓解率为７３％，显著高于不伴ｔ（８；２１）患者的４３％（Ｐ＜０．０５）。结论免疫分型时ＦＣＭ的敏感性高于ＦＭ；Ｍ２／ｔ（８；２１）的免疫表型存在不同步表达；ｔ（８；２１）是预后好的指标，判断ＣＤ３４等免疫标志的预后意义时必须结合细胞遗传学、Ｐ┐糖蛋白及临床特征等因素综合考虑     

非何杰金淋巴瘤患者基因克隆性标记的研究

对非何杰金淋巴瘤（ＮＨＬ）２５例、良性反应性淋巴结细胞增生１０例，在单克隆抗体免疫学分型的基础上，用体外基因扩增聚合酶链反应（ＰＣＲ）技术检测了免疫球蛋白重链（ＩｇＨ）和Ｔ细胞受体（ＴＣＲ）基因重排。结果表明，ＩｇＨ和ＴＣＲγ基因重排分析有助于从分子水平上确定肿瘤细胞的来源及其分化阶段，是恶性淋巴瘤可靠的分子克隆性标记，对鉴别诊断良、恶性淋巴结肿大疾病有重要的临床应用价值。     

Immunophenotype of blast cells in acute myeloid leukemia may be a useful predictive factor for outcome

The immunophenotype of peripheral blood blast cells was tested in 92 patients with acute myeloid leukemia (AML), who were diagnosed and treated at single centre, St Bartholomew's Hospital, from 1978-1987 with a standard adriamycin, cytosine arabinoside and 6-thioguanine regimen. Immunological analysis involved standard fluorescence flow cytometry and utilized 31 monoclonal antibodies to known myeloid antigens (of CD groups 11b, 11c, 13, 14, 15, 16, w17, 31, w32, 33, 34, 35 and 36), a number of relatively less well studied antibodies with potential specificity for AML, and a series of control antibodies to T and B lymphocytes, platelets, erythrocytes and of widespread distribution (CD45, leucocyte common; HLA-DR). The results highlighted a number of antibodies with wide myeloid reactivity, in addition to CD13 and 33 (present in 66 per cent and 76 per cent of cases, respectively), which may be of immunodiagnostic use. A number of correlations between AML cell immunophenotype and FAB morphology subtype were found; in particular five antibodies (CD11c, 10.1, Tu3, CD15 and CD16), of both predominant granulocytic and monocytic reactivity, reacted with cells of AML-M5 subtype (p less than 0.05). There was no significant correlation between immunophenotype and clinical and pathological features at presentation. Correlation with clinical outcome was not a prominent feature, in contrast to some reports based on multicentre data. However, of particular note was the strong association between early death (at less than 2 months) and the coexpression of Leucocyte Function Associated (LFA) antigens, CD11b and 11c, on patient's blast cells (p = 0.003). The relationship was independent of clinical features and persisted even if AML-M5 cases were excluded. The significance of this latter finding is unclear, but may be related to the known role of CD11b and 11c LFA antigens in the cellular response to infection.     

Immunophenotypic analysis of feline haemolymphatic neoplasia using flow cytometry

Tissues from 17 cats with suspected haemolymphatic neoplasia were analysed using phenotypespecific monoclonal antibodies (MAbs) and flow cytometry. Eight of the cases were also classified according to the French-American-British (FAB) system for acute leukaemias and were characterised by cytochemical staining. Phenotypes identified by the panel of MAb employed here included T lymphocyte, CD4+ lymphocyte, CD8+ lymphocyte, undifferentiated lymphocyte, erythroid or myeloid. By combining the cytological diagnosis of neoplasia with the phenotype, a precise diagnosis was obtained in 15 of the 17 cases. Of the 15 cases successfully phenotyped, eight were T-cell, two were B-cell, one was myeloid, two were erythroid, and two were mixed erythroid and myeloid. Two samples that did not react with the panel of MAb were determined at necropsy to be of non-haemolymphatic origin. Expression of feline leukaemia virus (FeLV) by neoplastic cells was demonstrated in three of seven FeLV-positive cats. The lack of a B-lymphocyte-specific MAb was the most significant deficit in the antibody panel and precluded conclusive identification of B-cell leukaemias. The FAB classification provided a more objective means to identify myelodysplastic syndrome versus myeloproliferative disorder. Cytochemical staining confirmed flow cytometric results in non-lymphoid neoplasias but otherwise did not refine the phenotypic diagnosis made by flow cytometric analysis. In the cases presented here, immunophenotyping with flow cytometry and our panel of MAbs, accurately identified lymphoid versus non-lymphoid neoplasia, as well as single and mixed lineage myeloproliferative disorders.     

骨髓形态学在单核细胞白血病诊断中的作用

目的探讨骨髓形态学（包括细胞化学染色）在急性单核细胞白血病（AML-M5）和急性粒一单核细胞白血病（AML-M4）形态学、免疫学及细胞遗传学（MIC）分型中的作用。方法对47例初治AML的骨髓穿刺标本进行形态学、免疫表型和染色体检查，并对检查结果进行分析。结果47例形态学诊断为AML-M4和AML-M5的患者最终经MIC分型诊断为AML-M525例；AML-M419例（其中AML-M4Eo5例）；t（8；21）AML2例；T细胞性急性淋巴细胞白血病（T-ALL）1例。结论在AML-M4及AML-M5的MIC分型中，骨髓形态学仍具有重要的的诊断价值，免疫分型和染色体检查与形态学相互依存，有助于进一步提高诊断的准确率。     

CD-10的B-ALL和NHL以及CLL免疫表型检测结果分析

目的 比较急性Ｂ淋巴细胞性白血病（Ｂ－ＡＬＬ）,非霍奇金淋巴瘤（ＮＨＬ）和慢性淋巴细胞性白血病（ＣＬＬ）免疫表型表达的区别。方法 采用ＡＢＣ－ＡＰ法结合多种Ｂ淋巴细胞相关单克隆抗体,对７８例初发Ｂ－ＡＬＬ（均为ＣＤ＾－１０的病例）、２１例初发ＮＨＬ和２５例初发ＣＬＬ患者进行免疫表型检测。结果 ＣＤ＾－１０的Ｂ－ＡＬＬ患者的白血病细胞以ＣＤ１９和ＨＬＡ－ＤＲ呈高阳性率表达;ＮＨＬ患者的肿瘤细胞以ＣＤ