成年人伴CD2表达B系急性淋巴细胞白血病免疫表型特征分析

 目的　了解成年人伴CD2表达B系急性淋巴细胞白血病（CD+2 B-ALL）的免疫表型特征，为临床诊断、治疗及预后判断提供依据。方法　应用流式细胞术及多种单克隆抗体检测18例成年人CD+2 B-ALL及68例CD-2 B-ALL患者的免疫表型，并对其结果进行分析比较。结果　CD+2 B-ALL的发病年龄明显小于CD-2 B-ALL，18例成年人CD+2 B-ALL的大部分表面标志物与CD-2 B-ALL相似，其中CD10表达水平[（73.78±26.67）%]高于CD-2 B-ALL[（52.84±35.25）%]，差异有统计学意义（t＝2.35，P＜0.05），CD33表达水平[（15.46±27.41）%]则低于CD-2 B-ALL[（31.15±27.72）%]，差异有统计学意义（t＝2.16，P＜0.05）；所有B-ALL患者都高表达CD34，阳性表达率分别为72.2 %（13／18）和80.9 %（55／68），差异无统计学意义（χ2＝0.64，P＞0.05）。CD+2 B-ALL的CD20阳性率明显低于CD-2 B-ALL，差异有统计学意义（χ2＝11.38，P＜0.05）。CD+2 B-ALL伴髓系抗原（CD13或CD33）表达率为44.4 %（8／18），明显低于CD-2 B-ALL 的72.1 %（49／68），差异有统计学意义（χ2＝4.86，P＜0.05）。结论　成年人CD+2 B-ALL与CD-2 B-ALL具有相似的免疫表型，主要来源于造血干细胞的恶性转化，CD+2 B-ALL伴髓系抗原（CD13、CD33）及CD20表达明显低于CD-2 B-ALL，提示成年人CD+2 B-ALL可能有较好的预后。

Immunophenotypic features of adult CD+2 B cell acute lymphoblastic leukemia

Objective To study the immunophenotypic feature of CD2^＋ adult B cell acute lymphoblastic leukemia （CD2^＋ B-ALL） and provide evidences for the diagnosis, therapy and prognosis. Methods The immunophenotypes of 18 cases of adult CD2^＋ B-ALL and 68 cases of adult CD2^- B cell acute lymphoblastic leukemia（CD2^- B-ALL） were assayed by a panel of monoclonal antibodies （McAbs） with FACS. Results The age of CD2^＋ B-ALL adults was younger compared to that of CD2^- B-ALL. The patients in the CD2^＋ group were similar to CD2^＋ group for the expression of most of the cell surface antigens assayed. However, it was notable that expression frequencies of CD10 [（73.78±26.67） %] in CD2^＋ B-ALL was higher than those in CD2 B-ALL [（52.84±35.25） %] （t = 2.35, P 〈0.05） and CD33 [（15.46±27.41） %] were significantly lower than that of CD2^＋ B- ALL [（31.15±27.72） %] （t = 2.16, P 〈0.05）. Both groups showed high positive expression for CD34 72.2 % （13/ 18） and 80.9 % （55/68）, respectively （X^2 = 0.64, P 〉0.05）. The CD20 expression in CD2^＋ B-ALL was lower than that in CD2 B-ALL significantly （X^2 = 11.38, P 〈0.05）. The myeloid antigen （CD13 or CD33） expression in CD2^＋ B-ALL 44.4 % （8/18） was lower than that in CD2^- B-ALL 72.1%（49/68） （X^2 = 4.86, P 〈0.05）. Conclusion Patients in the CD2^＋ B-ALL were similar to CD2 B-ALL for expression of most of the cell surface antigens assayed. CD2^＋ B-ALL showed low expression frequency of myeloid antigens （CD13, CD33） and CD20 antigens than CD2^＋ B-ALL. These results suggested that those with the CD2^＋ B-ALL immunophenotype generally presented with favorable prognostic features and usually could achieve good outcomes after treatment.