不同年龄段成人急性淋巴细胞白血病免疫表型差异分析

本研究探讨不同年龄段成人急性淋巴细胞白血病（ALL）免疫表型特点。应用CD45／SSC设门的四色流式细胞术和一组系列相关单克隆抗体对260例不同年龄阶段的成人ALL进行免疫表型分析。结果显示：①82例成人T细胞急性淋巴细胞白血病（T-ALL）CD7的阳性率为100％，CD2的阳性率随年龄增长显著降低，14—18岁组CD2阳性率（91．67％）显著高于19—35岁组（65．71％）和35岁以上组（43．48％）（P〈0．05）；CD34和HLA—DR的阳性率随年龄增长而增高，35岁以上组甩A-DR阳性率（39．13％）显著高于14—18岁组（4．17％）和19—35岁组（11．43％）（P〈0．05）；35岁以上组髓系抗原（MyAg）和CD13阳性率分别为65．22％和52．17％，显著高于19—35岁组（34．29％和22．86％）（P〈0．05）。②178例成人B细胞急性淋巴细胞白血病（B—ALL）CD19和HLA—DR阳性率为100％，除19—35岁组CD33阳性率（52．70％）显著高于14—18岁组（32．50％）外，其余各表面抗原在不同年龄阶段组表达的差异无统计学意义。结论：不同年龄段成人T—ALL免疫表型具有较强的异质性，年长成人T-ALL存在多种具有不良预后意义的表面标志异常表达；不同年龄段成人B—ALL的异质性似较成人T—ALL小。

Immunophenotyping Characteristics of Adult Patients with Acute Lymphoblastic Leukemia in Different Ages

The purpose of this study was to investigate the immunophenotying characteristics of adult acute lymphoblastic leukemia （ALL） patients in groups of different ages. Immunophenotyping was performed in 260 ALL patients by flow cytometry using a panel of monoclonal antibodies and CD45/SSC gating. The results indicated that （ 1 ） all the 82 cases of T-cell acute lymphoblastic leukemia （T-ALL） expressed CD7 （100%） while the positive rate of CD2 remarkablely decreased with aging. The positive rate of CD2 in patients aged 14 to 18 years （adolescents） was 91.67%, which is significantly higher than that in cases aged 19 to 35 years （young adults） and 〉 35 years （older adults ） （65.71% and 43.48% respectively ,p 〈 0.05 ） ; the positive rate of CD34 and HLA-DR increased with aging, there was significant difference of the HLA-DR expression between the older adults group （39.13%） and the other two groups （4.17% in adolescents and 11.43% in young adults respectively （p 〈 0.05 ）. Moreover, there were significant differences of the myeloid antigen （MyAg） and CD13 expression between the older adults and younger adults （p 〈 0. 05）. （2） As to adult B-cell acute lymphoblastic leukemia （B-ALL）, the positive rates of CDI9 and HLA-DR in 178 cases were 100% ; the positive rate of CD33 in young adults was significant higher than that in adolescents （p 〈 0.05 ）, the differences of the other marker expressions failed to reach statistical significance in adult B-ALL patients. It is concluded that the immunophenotypes of adult T-ALL are evidently heterogeneous in different ages, and expression with more aberrant phenotypes indicates poor prognostic significance in patients older than 35 years. There is no significant association of immunophenotypes with ages among different age groups of adult B-ALL.