儿童期急性白血病免疫分型诊断新方案的临床应用

目的 建立一种胞膜与胞浆抗原相结合、特异与敏感标志相结合的三色流式细胞术检测方法，研究儿童期急性白血病的免疫表型特点。方法 用CD45／SSC双参数点图区分白血病细胞和正常血细胞后，先用系列特异和敏感指标确定白血病细胞的系列来源，然后根据不同系列来源进一步检测。结果 CD45／SSC能明确区分白血病细胞和正常血细胞。胞浆抗原cCD79a、cCD3和MP0分别是B-ALL、T-ALL和AML的特异性抗原，且能够覆盖白血病分化的各阶段。CD19和CD7分别是B-ALL和T-ALL的系列敏感抗原。这两类抗原的结合在确定急性白血病的系列来源时特异、敏感、可靠，避免了仅用胞膜标记时因抗原跨系表达而获得可疑结果。结论 该方案可提高儿童期白血病免疫分型诊断的准确性，对患者的预后进行评估，是一种值得推广的免疫分型方案。

Novel flow cytometric immunophenotyping protocol for acute childhood leukemia and its clinical significance

Objective To establish a three-color flow cytomelric protocol which combines both surface and cytoplasm, specific and sensitive makers, and to evaluate its clinical significance in childhood acute leukemia, Methods The CD45/SSC dot plot was used to distinguish normal cells and leukemic blasts. The antibody combination , composed of different lineage distinctive and lineage sensitive markers was first applied to determine the lineage originality of leukemia cells. The markers used in the second step measurement were based on the findings of the first step. Results CD45/SSC dot plot could effectively distinguish normal and leukemic cell populations. Cytoplasmic antigens like cCD79a, cCD3 and MPO were B-ALL, T-ALL and AML lineage specific markers, respectively; they covered a wider extent of differentiation stages of leukemic cells. CD19 and CD7 were sensitive surface markers of B-ALL and T-ALL, All cases were accurately defined by combining these two categories of markers. No ambiguous results caused by co-expression of two lineage distinctive makers were obtained, Conclusion The protocol can significantly improve the accuracy of measurement of immunophenotypes of childhood leukemia and provide information to evaluate the prognosis of patients. It is a worthy effective protocol for both patients and laboratories.