急性白血病细胞形态学与免疫学分型的关系

背景与目的：近年来应用流式细胞术对白血病进行免疫学分型,可以了解细胞的来源及其分化阶段,提高急性白血病诊断分型的准确性.免疫学分型所反映的细胞分化水平与FAB细胞形态学分类有一定的相关性,但两者又不完全一致.本研究将探讨细胞形态学FAB分型与免疫学分型在急性白血病诊断中的相互关系.方法：2001年1月-2005年1月,本院初诊的302例急性白血病患者进行细胞形态学FAB分型,同时采用流式细胞术进行免疫学分型,比较两者在急性白血病诊断分型上的异同.结果：本组急性白血病FAB分型与免疫学分型具有较好的一致性,总符合率为89.7%,其中两者不相符合的白血病类型主要是急性混合细胞白血病（BAL）和急性未分化型白血病（AUL）.由免疫学分型诊断的BAL在FAB分型方面包括AML-M1、M2、ALL-L1、L2,其中L2最多见,其次是M1.结论：免疫学分型与FAB形态学分型有较高的符合率,应互相结合、互相补充,尤其对于怀疑BAL、AUL或形态学不典型的病例应尽早进行免疫学分型检测,以免误诊或漏诊.

The correlation of cell morphological classification and immunological classification in acute leukemia

Background and purpose:In recent years, immunological classification is widely used in acute leukemia by flow cytometry. It is helpful to learn the source and the differentiated stage of the cell, and it can also help to increase the accuracy of the classification of acute leukemia. This study was to investigate the correlation between FAB cell morphological classification and immunological classification in acute leukemia. Methods:FAB classification was analyzed in 302 cases with first-diagnosed acute leukemia in our hospital from January 2001 to January 2005. The immunophenotype was studied by using FACS, and the relationship of two types of classification was analyzed.Results:The FAB classification was quite consistent with the immunological classification, the total coincidence was 89.7%. The types of acute leukemia in which the two classifications were most inconsistent were biphenotypic acute leukemia (BAL) and acute undifferentiated leukemia (AUL). The FAB classification of BAL included AML- M1,M2,ALL-L1,L2,and among them, L2 was most common, M1 was the next.Conclusions:The FAB classification was correlated well with the immunological classification. Both of them should be combined to in the diagnosis of acute leukemia, especially for BAL, AUL and some cases for which the morphological characteristics was not typical.