双系表型急性白血病的免疫分型特点及疗效分析  

Immunophenotyping Characteristics of Biphenotypic Acute Leukemia and Analysis of Curative Effect

作　　者：张婧婧[1] 张楠[2] 张新富 石瑛[4] 王辉[1] 

机构地区：[1]新乡医学院医学检验系,河南新乡453003 [2]新乡医学院教务处,河南新乡453003 [3]新乡医学院三全学院,河南新乡453003 [4]郑州大学第三附属医院,河南郑州450007

出　　处：《中国实验血液学杂志》2011年第2期317-320,共4页Journal of Experimental Hematology

摘　　要：本研究探讨双表型急性白血病(biphenotypic acute leukemia,BAL)的免疫分型特点及疗效分析。采用流式细胞术四色免疫荧光直接标记技术与CD45/SSC设门分析技术检测45例疑似BAL患者,根据欧洲白血病免疫分类组(EGIL)积分标准进行分型。结果表明,45例疑似BAL患者中My/B-ALL的有23例,均共同表达cCD79a和cMPO,胞膜抗原CD19表达量最高,其次为CD10;My/T-ALL有18例,均共同表达cCD3和cMPO,胞膜中CD7表达最高,其次为CD5;T系和B系抗原共同表达的有4例,均共同表达cCD3和cCD79a。BAL患者中30例表达cTdT,25例表达CD34,31例表达CD117;My/B-ALL与My/T-ALL患者抗原表达中,CD33表达率高于CD13。CD34+的My/B-ALL的CR率低于CD34-My/B-ALL的CR率,CD34+My/T-ALL的CR率低于CD34-My/T-ALL的CR率。结论:双表型急性白血病以My/B-ALL系抗原共同表达最常见,其次为My/T-ALL。cCD3、cCD79a、cMPO对诊断及鉴别双表型急性白血病极为重要。流式细胞术是诊断双表型急性白血病最特异的方法。低分化细胞的BAL的临床预后不佳。This study was aimed to investigate the immunophenotyping characteristics of biphenotypic acute leukemia（BAL） and to analyze its curative efficacy.The four-color direct immunofluorescence staining and CD45/SSC gating analysis of flow cytometry were used to detect the cells of bone marrow and peripheral blood of 45 doubtful cases of BAL,and the immunophenotyping was performed according to the European Group for the Immunological Classification of Leukemia（EGIL） score criterion.The results showed that among 45 doubtful cases of BAL,the co-expression of cCD79a and cMPO was observed in 23 cases of My/B-ALL,with highest level of CD19 expression,followed by CD10;the co-expression of cCD3 and cMPO was observed in 18 cases of My/T-ALL,with highest level of CD7 expression,followed by CD5;the co-expression of cCD3 and cCD79a was found in 4 cases of T/B.Out of 45 cases of BAL,30 cases showed cTdT expression,25 cases showed CD34 expression,31 cases showed CD117 expression.The results also indicated that the expression rate of CD33 was higher than that of CD13 in antigen expression of My/B-ALL and My/T-ALL patients.The completc remission（CR） rate of My/B-ALL with My/T-ALL CD34＋ was lower than that of My/B-ALL with CD34-,the CR rate of My/B-ALL with CD34＋ was lower than that of My/T-ALL with CD34-.It is concluded that the co-expression of My/B-ALL antigen has been found to be most common,then followed by My/T-All.cCD3,cCD79a,cMPO have important value for diagnosing and identifing of BAL.The flow cytometry with four-color direct immunofluorecence staining is most specific method for diagnosis of BAL.The clinical prognosis of BAL with low cell differentiation is poor.

关 键 词：双表型急性白血病 免疫分型 流式细胞术 

分 类 号：R733.71[医药卫生—肿瘤]