流式细胞仪在儿童急性B淋巴细胞性白血病免疫分型中的应用

目的研究流式细胞仪检测儿童急性B淋巴细胞性白血病（B—ALL）免疫分型的临床价值，并探讨与预后的关系。方法利用流式细胞仪对39例B—ALL患儿在初诊时进行免疫分型。CD45-SSC设门，在CD19、CD10、CD20和CD22中选择两个单克隆抗体组合，进行三色组合分析。髓系抗体选用CD33和CD13根据是否伴有髓系抗原表达分为两组，并随访预后。结果①CD19、CD22、CD10的阳性率都超过或接近90％，分别为CD19：94．87％，CD22：92．31%，CD10：87．18％，而CD20只有15．38％的阳性率；有33．33％的患儿检测到髓系抗原（My）标志，其中以CD^13^＋8例，CD33^＋5例；②共有6例患儿复发，两组经，精确概率法检验，P〉0．05，差异无统计学意义。结论①流式细胞仪可以用于绝大多数的B—ALL患儿免疫表型的检测；②伴有髓系表达不具有提示复发的意义。

Immunophenotype of acute B-lineage lymphoblastic leukemia in children by flow cytometry

Objective To investigate the value of detecting immunophenotypes by flow cytometry （FCM） in B-lineage acute lymphoblastic leukemia （B-ALL） and discuss the relationship between immunophenotype and outcome. Methods 39 children with B-ALL were enrolled at diagnosis and immunophenotypes were detected by FCM. Gating was performed using the CD45-SSC plot. Various combinations with two monoclonal antibodies among CD19 ,CD10 ,CD20 and CD22 were analyzed with three-color stainings. CD33 and CD13 were used as myeloid antibodies for B-ALL with myeloid markers. 2 groups were divided by myeloid markers. Results ①The positive rates of CD19 ,CD22 and CD10 were 94. 87% ,92. 31% , and 87.18% respectively. The positive rates of CD20 was only 15.38%. CD13 and CD33 were expressed in 33.33% children with B-ALL,in which 8 cases of CD13 positive and 5 cases of CD33 positive were included. ②There are 6 patiens relapse. There were no significance between 2 groups by Fisher＇ s Exact Test（ P 〉 0. 05 ）. Conclusion ①Flow cytometry can be used to detect immunophenotypes in the majority of children with B-ALL. ②Myeloid markers in acute B-ALL are not the risk factors of relapse.