儿童与成人急性B淋巴细胞白血病免疫表型的差异分析

目的:对儿童和成人急性B淋巴细胞白血病(B-ALL)免疫表型存在的差异进行分析，探讨不同年龄段B-ALL分型特征和临床意义。方法:以260例儿童和127例成人B-ALL患者为研究对象，使用流式细胞术对患者初发时骨髓标本进行免疫表型检测，分析抗原表达情况。结果:在全部B-ALL患者中B系抗原阳性率高的抗原有CD19，CD22，CD79a，分别达到了100%，99.73%，99.19%；而成熟B系抗原CD20和cIgM阳性率为31.27%和21.29%，阳性率较低。 CD10的阳性率为94.88%，在成人组和儿童组中存在明显差异，儿童组明显高于成人组(P＜0.05)。造血干/祖细胞抗原CD34、HLA-DR、CD38、cTdT阳性率分别为76.82％、98.38％、98.92％和92.72%，其中儿童患者CD34明显低于成人患者(P＜0.05)。髓系相关抗原CD33、CD13和CD15的表达最常见，分别达20.49％、20.49％、7.01％，其中CD33和CD15在儿童组中阳性率明显低于成人组(P＜0.05)。结论:免疫分型对儿童与成人B-ALL的诊断和微小残留病检测方案选择具有重要意义。

Analysis of lmmunophenotypes in children and adults with B-cell acute lymphoblastic leukemia

Objective:To analyze the difference of immunophenotype in B-ALL between children and adults patients and to explore its phenotype characteristics and clinical significance.Methods:Bone marrow samples from 260 children and 111 adults initial B-ALL patients were selected for the study.Flow cytometry was used to detect the immunophenotype and analyze the expression of antigens.Results:B-cell associated antigen CD19,CD22 and CD79a were shown to have higher expression in all B-ALL patients with the rate of 100%,99.73%,99.19%.Antigen for mature B-cell CD20 and cIgM were shown to have lower expression in all B-ALL patients with the rate of 31.27% and 21.29%.CD10 expression was observed in 94.88% B-ALL patients and significantly higher in children compared with adults B-ALL patients (P＜0.05).Stem/progenitor cell marker antigen CD34,HLA-DR,CD38 and cTdT expression were 76.82％,98.38％,98.92％ and 92.72%.CD34 expression was significantly lower in children compared with adults B-ALL patients (P＜0.05).The myeloid antigen CD33,CD13 and CD15 were shown to have higher expression in all B-ALL patients with the rate of 20.49%,20.49% and 7.01%.CD33 and CD15 expression were significantly lower in children compared with adults B-ALL patients (P＜0.05).Conclusion:The immunophenotype played an important role in diagnosis and antibody panel in minimal residual disease detection in children and adults with B-ALL.