急性白血病细胞胞膜及胞浆抗原检测及意义

目的检测急性白血病(AL)患者胞膜及胞浆抗原,探讨其在AL免疫学分型中的作用.方法采用直接免疫荧光法对31例AL患者骨髓或外周血进行抗原标记染色(胞浆内抗原须先做破膜处理),以CD45/SSC设门法行三色流式细胞术分析.结果16例AML以CD13、CD33表达为主,分别占56%和75%,MPO表达也较高,占69%,4例伴淋系抗原表达者MPO( );9例B-ALLCD10、CD19阳性率均为100%,CD22(-),CyCD79a阳性率100%,CyCD22阳性率14%;6例T-ALL CD5、CD7阳性率100%,CD3阳性66%,CyCD3阳性100%.ALL组髓系抗原表达以CDl3、CD33多见.全部病例CD34表达较高,AML组占53.3%,ALL组为64%.结论检测急性白血病患者胞膜及胞浆抗原,可准确的对AL进行免疫学分型,当膜表面抗原难以确定类型时,胞浆内抗原(MPO,CyCD79a,CyCD22和CyCD3)检测意义更大.CyCD79a在协助诊断B-ALL时,敏感性及特异性均高于CyCD22.

Significance of determining immmunophenotype in acute leukemia

Objective:To evaluate the role of immunophenotype in classification of acute leukemia(AL).Methods:The bone marrow or blood in31 cases of patients with AL were tested by flow cytometry to determine the immunophenotype.Results: In 16 AML patients, the expressions of CD13and CD33 were higher, CD13 were 56%;CD33 were 75%;MP0 expressions were 69%;MPO( ) in 4 cases of Ly AML. In 9 B-ALL patients, the positive rate in CD10 and CD19 were 100%;CD22(-);CyCD79a 100%;CyCD22 14%.In 6 T-ALL patients, the positive rate in CD5 and CD7 were 100%;CD3 66%; CyCD3 100%. the expressions of CD34 were higher in all cases, it was 53. 3% in AML and 64%in ALL.Conclusions:AL can be classified correctly by determining the immunophenotype. The cytoplasma antigens are more important than membrane antigens when it is difficult to classify the AL. CyCD79a is more sensitive than CyCD22 in classfication of B-ALL.