cMPO/cCD79α/cCD3/CD45抗体组合在交叉系列抗原表达急性白血病诊断中的应用

目的探讨cMPO／cCD79α／cCD3／CIM5抗体组合在胞膜交叉系列抗原表达急性白血病（AL）诊断中的意义。方法采用流式细胞术对269例成人初发AL患者中胞膜交叉系列抗原表达的60例患者加做胞质抗体组合cMPO／cCD79α／cCD3／CD45。结果269例AL患者中有54例（20．1％）加做胞质抗原组合后仅出现一种胞质抗原表达而诊断为交叉系列抗原表达白血病，交叉系列抗原表达白血病在T细胞急性淋巴细胞白血病（T—ALL）、B—ALL及急性髓系白血病（AML）中的比例分别为28．6％、43．6％及13．4％。CD7、CD19、CD5和CD20在交叉系列抗原表达AML中的出现频率依次为65．4％、15．4％、11．5％和7．7％；CD13、CD33、CDl5在交叉系列抗原表达ALL中的出现频率依次为89．3％、21．4％、3．6％；6例（2．3％）患者出现二系胞质抗原表达，诊断为急性双表型细胞白血病，其中T／B型2例、B／M（B／髓系）型4例。结论胞质抗体具有系列特异性，四色组合流式细胞．免疫表型技术能提供快速多参数的分析数据。为保证实验结果的准确性，在对异常细胞免疫分型时应以CD45／SSC设门和正常细胞作内部参照。

Application of a four antibody (cMPO/cCD79α/cCD3/CD45) combination to the diagnosis of acute leukemia expressing cross-lineage antigens

OBJECTIVE: To explore the diagnostic value of intracellular antibody combination in acute leukemia (AL) expressing cross-lineage cell-surface antigens. METHODS: Flow cytometric immunophenotyping using intracellular antibody combination (cMPO/cCD79alpha/cCD3/CD45) was performed additionally in 60 patients who expressed cross-lineage antigens from 269 previously untreated adult AL. RESULTS: Fifty-four of 269 previously untreated adult AL patients who expressed only one kind of intracellular antigen were diagnosed as cross-lineage AL, the percentage of cross-lineage AL in T cell acute lymphoblastic leukemia (T-ALL), B-ALL and acute myeloid leukemia (AML) was 28.6%, 43.6% and 13.4%, respectively. The positive rate of CD7, CD19, CD5 and CD20 in cross-lineage AML was 65.4%, 15.4%, 11.5%, and 7.7%, respectively. The positive rate of CD13, CD33 and CD15 in cross-lineage ALL was 89.3%, 21.4% and 3.6%, respectively. Six (2.3%) patients expressed two-lineage intracellular antigens were diagnosed as biphenotypic AL: 2 of T/B type and 4 B/M (B/myeloid) type. CONCLUSION: Intracellular antibodies possess lineage specificity and four-color combination flow cytometric immunophenotyping can provide fast and multi-parameter data. To ensure accuracy of the results, CD45/SSC gating and normal cells as internal reference should be used in the immunophenotyping of abnormal cells.