51例慢性淋巴细胞白血病的免疫表型及细胞遗传学特征研究

本研究探讨慢性淋巴细胞白血病（CLL）的免疫表型及细胞遗传学特征,为其诊断及治疗提供依据。采用一组系列相关单克隆抗体和三色流式细胞术对51例CLL患者进行免疫表型分析,并应用R显带技术对这51例患者的细胞遗传学异常进行了研究。结果表明：51例CLL患者中,CD19和CD23阳性率为96.1%,其后依次为CD5（94.1%）、CD20（82.4%）和CD22（78.4%）,CD38阳性率为23.5%。CD5和CD19共阳性者46例（90.2%）。51例患者的染色体异常检出率为35.3%（18/51）,共检出7种主要异常核型,其中＋12有3例,13q-有2例,其它主要异常有＋14、6q-、t（11;14）、t（14;18）和t（2;7）等。各抗原表达与染色体异常无显著性差异（p〉0.05）。结论：典型CLL免疫表型为CD5、CD19和CD23阳性;常规细胞遗传学（CC）检测CLL染色体异常阳性率偏低;免疫表型结合细胞遗传学异常对CLL诊断及预后有重要价值。

Immunophenotypic and Cytogenetic Features in 51 Cases of Chronic Lymphocytic Leukemia

The study was aimed to investigate the immunophenotypic and cytogenetic features of chronic lymphocytic leukemia (CLL) in order to provide an evidence for diagnosis and therapy. Immunophenotypic analysis was performed by using a panel of monoclonal antibodies and three-color immunofluorescence staining methods of flow cytometry in 51 patients with CLL, and the cytogenetic features were analyzed by R-banding technique. The results indicated that among 51 CLL cases, the positive rate of CD19 and CD23 was 96.1%, followed by CD15 (94.1%), CD20 (82.4%) and CD22 (78.4%). The positive rate of CD38 was 23.5%. Forty-six patients expressed both CD5 and CD19. Seven main clonal chromosomal abnormalities were detected by conventional cytogenetics (CC) in eighteen cases (35.3%), with three cases of +12, two cases of 13q-, other chromosomal abnormalities included +14, 6q-, t(11;14), t(14;18) and t(2;7). Expression of the antigens had no relationship with chromosomal abnormalities. It is concluded that typical CLL express CD5, CD19 and CD23,and the positive rate detected by CC in CLL is low. Immunophenotyping in combination with cytogenetic technique plays an important role in the diagnosis and prognosis of CLL.