急性淋巴细胞性白血病跨系表达方式研究

目的 利用三色流式细胞术对急性淋巴细胞白血病（ALL）免疫表型跨系表达进行研究。方法 采用CD45／SSC双参数散点图设门方法对135例ALL（111例B-ALL，24例T-ALL）患者幼稚细胞表面及胞质内分化抗原进行分析。结果 在ALL中，髓系抗原（M）表达64％，T和B亚型中髓系抗原表达差异无显著性意义（P〉0．05），其中CD13表达最为常见（40％），其次是CD33（37％）、CD11b（20％）和CD15（16％），CD13和CD33在CD34^＋病例中的表达均高于CD34^-病例。B-ALL中，T系抗原CD4、CD2和CD7分别在19例、2例和2例中表达，CD4^＋和CD7^＋病例通常共表达CD13和（或）CD33；T-ALL中2例CD19表达者均伴CD13／CD33表达。结论 ALL伴髓系表达的频率较高（B^＋M^＋，T^＋M^＋），偶尔出现B系，T系和髓系共表达的表型（B^＋T^＋M^＋），B系T系共表达但不伴髓系表达的表型（B^＋T^＋M^-）极少，跨系表达多存在各未成熟的阶段，髓系抗原表达与干细胞表面标志CD34有一定的联系。

Pattern of Cross-Lineage Expression in Acute Lymphoblastic Leukemia

Objective To study the cross-lineage expression of acute lymphoblastic leukemia(ALL) with the use of multi-parameter flow cytometry in the immunophenotype of ALL.Methods Multiparameter flow cytometry and CD45/SSC gating were used to analyze the surface and cytoplasmic antigen expression in 135 cases of ALL(111 cases of B-ALL and 24 cases of T-ALL).Results In whole ALL,the expression of myeloid antigens occurred in 64 % of the cases,and the expression frequency had no significant tendency in T and B subtypes(P>0.05).The expression rate of CD13 was highest(40 %),followed by CD33(37 %),CD11b(20 %) and CD15(16 %).CD13 and CD33 expression were more frequent in CD34~( ) cases than in CD34~-cases.In B-ALL,T-cell antigen CD4,CD2 and CD7 were seen in 19,2,and 2 cases,respectively,and CD4~( ) and CD7~( ) cases commonly expressed CD13 and/or CD33(CD13/CD33).In T-ALL,B-cell antigen CD19 was found in 2 cases with CD13/CD33.Conclusion ALL cells frequently express B~( )M~( ),T~( )M~( ),and occasionally B~( )T~( )M~( ) phenotype,but B~( )T~( )M~-phenotype is extremely rare.Cross-lineage expression mostly exists in the immature stages,and myeloid antigens are associated closely with the presence of stem-cell antigen CD34.