185例儿童急性白血病流式细胞术免疫分型研究  

Immunophenotyping of 185 Children with Acute Leukemia by Flow Cytometry

作　　者：吴韶清 吴洁莹 廖灿 孙新 黄以宁 许遵鹏 刘光明 叶铁真 赖冬波 李焱 区小冰 颜慕霞 张力 陈劲松 

机构地区：[1]广州市妇女儿童医疗中心脐血库,广东广州510623 [2]广州市妇女儿童医疗中心血液科,广东广州510623

出　　处：《现代生物医学进展》2011年第16期3087-3091,共5页Progress in Modern Biomedicine

基　　金：广州市医药卫生科技项目(2009-YB-078);广东省医学科研基金(B2010274)

摘　　要：目的:探讨儿童急性白血病流式细胞术免疫分型的意义。方法:采用流式细胞术三色荧光标记技术和CD45/SSC双参数散点图设门,检测185例儿童急性白血病的免疫表型,对抗原表达情况进行分析。结果:流式细胞术免疫分型和FAB分型的符合率为89.19%。185例儿童急性白血病中,ALL为121例,占AL的65.41%,B-ALL为113例,主要表达B系的CD19(99.12%)、CD22(98.13%)、CD79a(96.19%)、CD10(86.73%)。T-ALL占8例;主要表达CD5(100%)、CD7(100%)、cCD3(100%)、CD8(87.5%)。AML为47例,占25.41%,主要表达CD33(93.62%)、CD15(78.72%)、CD64(76.6%)、MPO(76.6%)、CD13(74.47%)。在B-ALL,AML,T-ALL中,敏感性最高的抗体分别是CD19,CD33,CD5和CD7,特异性最强的抗体分别是CD79a,MPO,cCD3。AMLL为17例,占9.19%,其中B/M为9例,T/B为5例,T/M为3例。My十-ALL为54例,占ALL的44.63%,表达的髓系抗原为CD13、CD15、CD33、CD64。Ly+-AML为18例,占AML的38.30%,表达的淋系抗原为CD19、CD4、CD7。系列非相关抗原CD34的表达率为67.57%,HLA-DR的表达率为85.41%,CD38的表达率为80.59%,TdT的表达率为62.59%。结论:流式细胞术免疫分型在白血病分型中起重要作用,是FAB分型的补充和修正,提高了儿童急性白血病诊断的准确率有必要进一步加强流式细胞术免疫分型的标准化工作。Objective： To investigate the significance of immunophenotype in children＇s acute leukemia via flow cytometry. Methods： Immunophenotypes were detected by three-color flow cytometry （FCM） and CD45/SSC gating in 185 cases of acute leukemia （AL） and antigentic expressions were analysed. Results： The coincidence rate was 89.19% between FAB and immunophenotype. Among the 185 cases of AL, 121 （65.41%） were acute lymphoblastic leukemia （ALL）.In 113 cases of B-lineage ALL （B-ALL）, CD 19 （ 99.12% ）, CD22（98.13%） , CD79a（96.19%）, CD10（86.73% ）agents had high expression. CD19 was the most sensitive and CD79a was the most intense in specificity. In 8 cases of T-ALL, CD5 （ 100% ）, CD7 （ 100% ）, cCD3 （ 100% ）, CD8 （87.5%）agents had higher expression in T lymphoblastic, CD5 and CD7 were the most sensitive, cCD3 was the most intense in specificity./n AML, CD33 was high sensitivity and MPO was specificity. Myeloblastic agents were often expressed as follows： CD33 , CD15 ,CD64 , MPO , CD13 in the order of decreasing. 17 cases were acute mixed lineage leukemia, 9 cases were B/M, 5 cases were T/B and 3 case were T/M.My＋-ALL made up 44.63% of ALL express such myeloid antigens as CD13, CD15, CD33, CD64. 18 cases were Ly＋-AML, in which CD19,CD4 and CD7 were chiefly presented Lymphoid lineage associated antigents. The unlineage-associated antigens expression frequencies were as follows： CD34 （67.57%）,HLA-DR （85.41%）,CD38 （80.59%）,TdT （62.59%）. Conclusion： Immunophenotype plays an important role in the classification of children＇s acute leukemia and is a supplementary and correction of FAB phenotype. It can enhance the exactness of diagnosis and needs to be standardized.

关 键 词：儿童 急性白血病 流式细胞术 

分 类 号：R737.7[医药卫生—肿瘤]