多参数流式细胞术分析505例急性淋巴细胞白血病跨系列表达方式

跨系列抗原表达是白血病免疫表型的一个重要特征。对于急性淋巴细胞白血病（ALL）的跨系表达方式，目前国内尚缺乏大样本多参数的研究报道。本研究利用三色流式细胞术探讨505例ALL（431例B—ALL，74例T—ALL）患者23种系相关抗原的跨系表达方式。结果显示：全部ALL病例中，髓系抗原的表达率为56．4％，其中以CD13（32．7％）的表达最常见，其次为CD33（29．5％）、CD15（19．2％）和CD11b（7．7％）。CD13／CD33在CD34^＋病例中的表达高于CD34^＋病例。在B—ALL中，T系抗原CD4、CD5、CD7和CD2的表达率依次为6．3％、2．8％、1．9％和1．4％，并且CD7^＋、CD2^＋和CD4^＋病例通常共表达CDl3和（或）CD33。在T—ALL，B系抗原cCD79a、CD19和CD22的表达率分别为8．1％、6．8％、和2．8％，而全部CD19和CD22表达者均伴CD13／CD33表达。结论：ALL的跨系袁达多存在未成熟的阶段，以跨髓系抗原的表达最常见（B^＋M^＋，T^＋M^＋），偶有B系、T系和髓系抗原的共表达（B^＋T^＋M^＋），仅有B系和T系跨系表达的极少（B^＋T^＋M^-）。

Cross Lineage Expression in 505 Patients with Acute Lymphoblastic Leukemia by Multiparametric Flow Cytometry Analysis

The expression of immunological markers of one hematopoiefic lineage on the abnormal cells of another lineage(cross-lineage expression)is a known feature of leukemia.The present study was aimed to investigate the crosslineage expression in ALL ceils.The cross-lineage expression in ALL cells from 505 patients was detected by flow cytometry using 23 monoclonai antibodies(McAbs)in triple staining combinations.The results showed that in whole ALL,the expression of myeloid antigens occurred in 56.4% of the cases.and CD13 was the most frequently expressed myeloid marker(32.7%)followed by CD33(29.5%),CD15(19.2%)and CD11b(7.7%).CD13/CD33 expressions were more frequent in CD34+ cases than in CD34- cases.In B-ALL,T-cell antigen CD4,CD5,CD7 and CD2 were found in 27(6.3%),12(2.8%),8(1.9%),and 6(1.4%)cases respectively,and CD7+,CD2+and CD4+cascs commonly expressed CD13/CD33.In T-ALL,B-cell antigen cCD79a.CD19 and CD22 were found in 6 (8.1%),5(6.8%),and 2(2.8%)cases respectively,and all of CD19+ and CD22+ cases were all accompanied witll CD13/CD33.It is concluded that cross-lineage expression in ALL mostly exists in the imrnature stages.ALL cells more frequently express phenotypes B+M+,T+M+ and occasionally B+T+M+,but B+T+M- phenotype is extremely rare.