儿童急性淋巴细胞白血病免疫分型特征及其临床意义

目的：探讨急性淋巴细胞白血病（ALL）患儿的免疫分型及其与临床特征的关系。方法：139例ALL患儿为研究对象,取肝素抗凝的骨髓或静脉血2~3 mL,利用流式细胞仪进行免疫分型分析。结果：139例ALL患儿中,B-ALL 103例（74.1 %）,T-ALL 24例（17.3 %）,T/B双表型ALL 12例（8.6 %）。B-ALL主要表达的抗原有CD19（90.3%）、CD10（83.5%）、CD20（27.2%)。T-ALL主要表达的抗原有CD3（79.2%）、CD7（66.7%）、CD5（33.3%）。B/T-ALL主要表达的T系抗原有CD7（50.0%）、CD5（41.7%）;B系抗原有CD19（50.0%）、CD10（33.3%）。139例ALL患儿中,32例伴髓系抗原表达（My+）,主要表达的抗原有CD13、CD33、CD14、MPO等。139例ALL患儿中,31例表达CD34;而My+ ALL中CD34阳性表达（15.6%）明显低于My- ALL（24.3%）。139例ALL患儿中,82例表达HLA-DR。CD10、CD34、HLA-DR在标危、中危、高危型ALL中的表达差异有统计学意义。My+ ALL组性别、出血发生率与My- ALL组比较差异有统计学意义（P<0.05）。结论：免疫分型可正确区分儿童ALL的来源。CD10、CD34、HLA-DR抗原表达与ALL的临床分型有关。

Immunophenotyping and its clinical significance in childhood acute lymphoblastic leukemia

Objective To study the immunophenotype and its relationship with clinical characteristics in children with acute lymphoblastic leukemia(ALL). Methods Bone marrow or blood samples(2-3 mL) with heparin anticoagulation from 139 children with ALL were obtained,and immunophenotypes were identified by flow cytometry. Results In 139 ALL children,there were 103 cases(74.1%) of B-ALL,24 cases(17.3%) of T-ALL,12 cases of T/B biphenotypic(8.6% of T/BALL).In the 103 children with B-ALL,CD19(90.3%),CD10(83.5%) and CD20(27.2%) were expressed as major antigens.In the 24 children with T-ALL,the major antigens were CD3(79.2%),CD7(66.7%) and CD5(33.3%).In the 12 children with B/T-ALL,T-lymphoid antigens included CD7(50.0%) and CD5(41.7%),while the B-lymphoid antigens included CD19(50.0%) and CD10(33.3%).Of the 139 children with ALL,32 cases(23.0%) showed myeloid antigen expression(My+ ALL) and the main expression antigens were CD13,CD33,CD14 and MPO.CD34 was expressed in 31 cases.CD34-positive expression(15.6%) in My+ ALL children was significantly lower than in My-ALL children(24.3%).HLA-DR was expressed in 82 of the 139 ALL children.The expression of CD10,CD34 and HLA-DR in the standard-risk,medium risk,high-risk ALL children was significantly different.There were significant differences in gender and incidence of bleeding between the My+ ALL and My-ALL groups(P<0.05). Conclusions Immunetyping can differentiate the sources of leukemic cells.The expression of CD10,CD34 and HLA-DR antigen is related to the clinical classification of ALL.