急性白血病免疫表型分析及其临床意义

 目的 探讨急性白血病（AL）的免疫表型特点及其临床意义。方法 采用间接免疫荧光法检测分析107例AL患者的免疫表型。结果 CD33、CD13是急性髓系白血病（AML）中最有诊断价值的指标，CD14有助于AML-M4、AML-M5与其他亚型的区别。CD2、CD7是T淋巴细胞白血病（T-ALL）中最有诊断价值的指标，CD19、CD22是B淋巴细胞白血病（B-ALL）中最有诊断价值的指标。17例ALL患者伴髓系抗原（My+ALL）表达率为11.76 %，85例AML患者伴淋系抗原（Ly+AML）表达率为24.71 %。My+ALL和My-ALL患者的CR率分别为0和71.43 %，差异无统计学意义（P＞0.05）。Ly+AML和Ly-AML患者的CR率分别为33.33 %和80.95 %，差异有统计学意义（P＜0.01）。CD+34 AML和CD-34 AML患者的CR率分别为40.74 %和83.33 %，差异有统计学意义（P＜0.01）。HLA-DR+AML和HLA-DR-AML的CR率分别为48.15 %和79.63 %，差异有统计学意义（P＜0.01）。结论 免疫表型分析对AL的诊断以及治疗指导、预后判断等均具有重要意义。

The analysis of immunophenotype and its clinical significance in acute leukemia

Objective To evaluate the specificity of immunophenotype and clinical significance in a－cute leukemia(AL). Methods 107 patients with AL were detected with indirect immune fluorescence method.Results The most valuable parameter in diagnosis of acute myeloid leukemia(AML) was CD33, CD13, in T-lin－eage acute lymphoblastic leukemia (T-ALL) was CD2, CD7, and in B-lineage acute lymphoblastic leukemia(B-ALL) was CD19, CD22. Myeloid-associated antigen expressed in 11.76 % of the 17 patients with ALL. And lymphoid-associated antigen expressed in 24.71 % of the 85 patients with AML. The percent of CR in pa－tients with My+ALL and My-ALL was 0 and 71.43 %, respectively. And it in patients with ly+AML and ly-AML was 33.33 % and 80.95 %, respectively. As far as the pencent of CR, there was no difference between My+ALL and My-ALL(P >0.05). However there was a significant difference between Ly+AML and Ly-AML(P <0.01). At the same time, there was a significant difference between CD+34 AML and CD-34 AML (P <0.01) in the percent CR which was 40.74 % and 83.33 %, respectively. There was also a significant difference between HLA-DR+AML and HLA-DR-AML(P <0.01) in the percent of CR which was 48.15 % and 79.63 %, respec－tively. Conclusion The analysis of immunophenotype is extremely important in the diagnosis of acute leukemia, reliable diagnosis of some specific leukemia, guiding treatment and prognostic forcasing.