282例急性白血病流式细胞术免疫分型的特点分析

目的探讨急性白血病免疫表型特征及诊断价值。方法采用流式细胞术三色荧光直接标记技术检测282例AL患者,根据抗体积分系统进行分型。结果①按免疫表型的特征可将急性白血病分为4类:单表型急性白血病(82.27％),表达某一系列抗原为主的急性白血病(9.22％),急性杂合性白血病(HAL)(7.09％),未分化型急性白血病(AUL)(1.42％);②80％以上急性非淋巴细胞白血病(ANLL)患者主要表达MPO(96.38％)、CD13(89.86％)、CD33(69.57％),90％以上急性淋巴细胞白血病(ALL)主要表达cCD79a(100％)、CD19(93.67％)或cCD3(100％)、CD2(100％),表达某一系列抗原为主的AL以急性B淋巴细胞白血病伴随系表达(My B-ALL)为主(62.50％),HAL以B-ALL及MAL为主。结论流式细胞仪三色免疫荧光直接标记法进行AL免疫分型,cCD3、cCD79a、MPO为系列特异性标志,CD117为早期髓细胞的标志,对AL的诊断及一些特殊类型的白血病的确诊、治疗和预后均有重要意义。

Characteristic Analysis of Immunophenotyping Expressions of 282 Cases of Acute Leukemia

Objective To study the characteristic of immunophenotyping expressions of acute leukemia and the diagnostic value of that. Methods 282 cases of acute leukemia were detected by flow cytometry. three color direct immunofluo-rescence staining methods being used. And the antibody integration system was used to classify acute leukemia. Results Acute leukemia were classified into 4 subgruops:monophenotypic acute leukemia,acute leukemia which mainly expressed one lineage-specific antigens,hybrid acute leukemia (HAL) and acute undifferentiated leukemia (AUL). And the percentages of them were 82. 27%,9. 22%,7. 09% and 1. 72% respectively. More than 80% of acute nonlymphocytic leukemias (ANLL) expressed MPO,CD13 and CD33. And more than 90% of acute lymphocytic leukemias (ALL) expressed cCD79a, CD19 or cCD3,CD2. Most of acute leukemias which mainly expressed one lineage-specific antigens were acute B lymphocytic leukemia with expression of myeloid antigen. And most of HAL were acute B lymphocytic leukemia and acute myeloid leukemia. Conclusion cCD3,cCD79a and MPO are lineage-specific antigens,and CD117 is prophase myeloid antigen. And they are important in diagnosis,classification,treatment and prognosis of acute leukemia.