610例急性髓系白血病免疫表型和白血病相关免疫表型分析  

Analysis of immunophenotype and leukemia associated immunophenotype in 610 patients with acute myeloid leukemia

作　　者：刘艳荣[1] 王亚哲[1] 陈珊珊[1] 常艳[1] 付家瑜[1] 李玲娣[1] 王卉[1] 于弘[1] 江滨[1] 黄晓军[1] 

机构地区：[1]北京大学人民医院,北京大学血液病研究所100044

出　　处：《中华血液学杂志》2007年第11期731-736,共6页Chinese Journal of Hematology

基　　金：国家自然科学基金(30470738)

摘　　要：目的探讨急性髓系白血病(AML)患者免疫表型和白血病相关的免疫表型(LAIP)特征及在微量残留病(MRD)检测中的意义。方法采用 CIM5/SSC 设门四色流式细胞术,检测610例AML 患者和20名健康志愿者下列抗原的表达:CD7、CD117、CD33、CD34、CD10、CD19、CD56、CD38、CD13、CD14、CD64、CD9、CD16、CD2、CD5、CD11b、CD123、HLA-DR。结果正常骨髓中 CD34^+和CD117^+SSC 值低(SSC^(low))的细胞比例分别为(0.35±0.15)%和(0.76±0.31)%。CD34^+SSC^(low)细胞中绝大多数细胞共表达 CD13、CD33、CD38、CD117、HLA-DR(84%～94%)。CD9和 CD15的相对比例为20%和33%,而 CD11b、CD56、CD19和 CD64的相对比例均低于10%,CD7为12%。CD117^+SSC^(low)细胞中,CD19^+、CD11b^+、CD56^+和 CD7^+细胞相对比例低于10%,CD9^+细胞为14%,CD38^+和 HLA-DR^+细胞的相对比例为87%和91%,其余抗原(CD15、CD13、CD33、CD34)均在30%～50%。AML 患者中 CD117、CD38表达率约为95%,CD33、CD9表达率约为84%。HLA-DR 和 CD13表达率分别为77.23%和75.25%。CD64和 CD34的表达率分别为64.41%和59.51%。CD15表达率为43.06%,CD11b 表达率为22.07%。86.39%的 AML 患者 LAIP 阳性,以 AML-M_1和 M_3最高,AML-M_(4Eo)最低。LAIP 主要表现为交叉系列抗原表达和非同期共抗原表达,前者以 CD34与 CD7、CD19、CD56同时阳性为主。在非同期抗原表达中,CD34^+CD64^+、CD117^+CD11b^+、CD117^+CD38^(-/dim)、CD117^+HLA-DR^(-/dim)正常值在0.01%左右,与 AML 之间的对数差大于3,为灵敏度较高的 LAIP。结论多参数流式细胞术适于80%以上 AML 患者 MRD 检测。Objective To analyze the immunophenotype and leukemia associated immunophenotype （LAIP） of leukemia cells from patients with acute myeloid leukemia （AML） in minimal residual disease （MRD） detection. Methods Four-color multiparametric flow cytometry （FCM） with CIM5/SSC gating was used to determine the expression of the following antibodies of CD7, CD117, CD33, CD34, CD10, CD19, CD56, CD38, CD13, CD14, CD64, CD9, CD16, CD2, CD5, CDllb, CD123, HLA-DR in610 AML pa- tients and 20 normal bone marrow（NBM） samples. Results The mean percentages of CD34^＋ and CD117^＋ side scatter low （ SSC^low） cells in NBM mononuclear cells （BMMNCs） were （0. 35 ± 0.15 ） % and （0.76 ± 0.31 ） % , respectively. The majority （84% ±95% ） of CD34^＋ SSC^low ceils co-expressed CD13 ,CD33 ,CD38, CD117 and HLA-DR. 33% and 20% of CD34^＋ SSC^low cells were CD15^＋ and CD9^＋ , respectively. Only a small proportion （ 〈 10% ） of CD34^＋ SSC^low cell co-expressed CD1 lb, CD56, CD19 and CD64, while co-ex- pressed CD7 was 12%. In CDll7^＋ SSC^low cells, the relative proportions of CD19^＋, CDllb^＋, CD56^＋ and CD7^＋ were less than 10%, while CD9^＋ was 14%. CD38^＋ and HLA-DR^＋ were 87% and91% ,respectively. The expressions of CD15, CD34, CD13 and CD33 on CDll7^＋ SSC^low ceils were between 30% and 50%, In AML patients, most cases were CDll7^＋ （95. 08%）, CD38^＋ （94. 74%）, CD9^＋ （84.93%）, CD33^＋ （84.60%）, HLA-DR^＋ （77.23%） and CD13^＋ （75.25%）. The proportions of CD64^＋ and CD34^＋ were 64.41% and 59.51%, and that of CD15^＋ and CD11 b^＋ were 43.06% and 22.07 %, respectively. 86.39% of AML patients were found to have at least one LAIP, the highest incidence being in AML-M1 and M3 sub- types and the lowest in AML-M4Eo subtype. The cross-lineage antigen and asynchronous antigen expressionwere the most frequent aberrant phenotypes. CD7, CD19 and CD56 expressing on CD34^＋ cells were major cross-lineage antigen. For asynchronous antigen expression,

关 键 词：免疫表型分析 白血病 非淋巴细胞 急性 微量残留病 

分 类 号：R733.7[医药卫生—肿瘤]