129例急性白血病免疫表型特点分析

目的 了解急性白血病瘤细胞抗原表达特点,为急性白血病免疫分型诊断提供科学依据.方法 利用四色流式细胞学检验技术,以CD45/SSC双参数散点图设门法,测定129例急性白血病患者瘤细胞的抗原表达.结果 129例急性白血病中,cMPO在AML高表达,在ALL无表达.cCD79a和cCD22在B-ALL高表达,在AML和T-ALL无表达.cCD3和cTCRαβ在T-ALL高表达,在AML和B-ALL无表达.CD34是急性白血病瘤细胞低分化阶段的判断指标.CD64和CD14是单核细胞系诊断的重要指标,在M4和M5高表达.CD41和CD61在M7高表达.流式免疫分型和形态学检查诊断急性白血病的总符合率96.1%.结论 急性白血病瘤细胞免疫表型具有规律性,异常的抗原表达是瘤细胞诊断的依据,残存的正常抗原表达是急性白血病分类诊断的依据.瘤细胞绝对数量上的多寡不影响疾病的诊断,却是疾病疗效和复发的判断指标.流式白血病免疫分型在形态不典型白血病、跨系表达白血病及混合型白血病的诊断中具有独到优点.

Analysis of the immunophenotypic features of 129 patients with acute leukemia

Objective To investigate the characteristics of tumor antigen expression on neoplastic cells from patients with acute leukemia.Methods Immunophenotyping was performed by four-color flow cytometry with CD45/SSC gating for neoplastic cells from 129 patients with acute leukemia.Results Among the 129 patients,cMPO was highly expressed in AML,but not in ALL,cCD79a and cCD22 were highly expressed in B-ALL,but not in AML and T-ALL,and cCD3 and cTCRαβ were strongly expressed in T-ALL,but not in AML and B-ALL.CD34 was a significant marker for the lower differential stage of neoplastic cells.CD64 and CD14 were overexpressed in M4 and M5,and could be used as diagnostic markers for monocytic linage.CD41 and CD61 were highly expressed in M7.The total coincidence rate was 96.1% between immunophenotyping and traditional morphological phenotyping.Conclusion The immunophenotypes of neoplastic cells in acute leukemia display significant patterns.The abnormal expression of tumor antigen could be specific marker for neoplastic cells,and the expression of normal antigen could be used for categorization of acute leukemia.The absolute number of neoplastic cells might be an index of therapeutic effect and disease recurrence.Immunophentyping by flow cytometry could have its unique advantages for the diagnosis of morphological non-typical leukemia,leukemia with cross-linage antigen expression and leukemia with mixed lineages.