免疫分型对急性白血病诊断及预后诊断的意义

目的探讨免疫分型对急性白血病的分型诊断及预后诊断的价值。方法采用碱性磷酸酶抗碱性磷酸酶复合物(APAAP)法检测53例急性白血病患者的免疫分型。结果 免疫分型诊断急性髓系白血病(AML)27例,T淋巴细胞白血病(T-ALL)8例,B淋巴细胞白血病(B-ALL)10例,混合型自血病(ABL)6例,未分化型自血病(AUL)2例。T-ALL CD7阳性最常见,B-ALL CD19阳性最常见。AML中抗原表达依次为CD33>CD13>CD14>CD15,CD34/CD34/HLA-DR表达阳性率为64.2％。AML中阳性病例完全缓解率低于阴性病例。ABL及AUL治疗效果差。结论 白血病免疫分型可提高确诊率,并为预后判断提供依据。

Value of immune typing in diagnosis and prognosis of acute leukemia

Objective To analyse the expression of cell surface markers in acute leukemia (AL) and its relationship with prognosis. Method Immunophenotypes were examined using alkaline phosphatase anti-alkaline phosphatase complex immunohistochemistry in 53 AL. Results 27,8,10,6 and 2 cases were respectively diagnosed as myeloblastic (AML), T lymphoblastic (T-ALL), B lymphoblastic (B-ALL), acute biphenotypic leukemia (ABL) and undifterentiated leukemia (AUL) depending on immunophenotypes. The most often expressed antigens were CD7 in T-ALL and CD19 in B-ALL. The antigens with abnormal expression in AML were CD33, CD13, CD14 and CD15,in order of decreasing level. The incidence of CD34/HLA-DR expression was 64.2% in AL.CR rate of CD34/HLA-DR positive patients was lower than negative patients in AML(P < 0.05). ABL and AUL had a poor prognosis. Conclusion Immune typing improves the positive rate of diagnosis and has value in prognosis of AL.