儿童急性淋巴细胞白血病免疫分型特征及其临床意义  

Immunophenotyping and its clinical significance in childhood acute lymphoblastic leukemia

作　　者：张耀东[1] 谭利娜[1] 胡群[2] 卫海燕[1] 张小玲[2] 熊昊[3] 

机构地区：[1]郑州市儿童医院,河南郑州450052 [2]华中科技大学同济医学院附属同济医院儿科,湖北武汉430030 [3]武汉市儿童医院,湖北武汉430000

出　　处：《中国当代儿科杂志》2012年第3期188-191,共4页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨急性淋巴细胞白血病(ALL)患儿的免疫分型及其与临床特征的关系。方法 139例ALL患儿为研究对象,取肝素抗凝的骨髓或静脉血2～3 mL,利用流式细胞仪进行免疫分型分析。结果 139例ALL患儿中,B-ALL 103例(74.1%),T-ALL 24例(17.3%),T/B双表型ALL 12例(8.6%)。B-ALL主要表达的抗原有CD19(90.3%)、CD10(83.5%)、CD20(27.2%)。T-ALL主要表达的抗原有CD3(79.2%)、CD7(66.7%)、CD5(33.3%)。B/T-ALL主要表达的T系抗原有CD7(50.0%)、CD5(41.7%);B系抗原有CD19(50.0%)、CD10(33.3%)。139例ALL患儿中,32例伴髓系抗原表达(My+),主要表达的抗原有CD13、CD33、CD14、MPO等。139例ALL患儿中,31例表达CD34;而My+ALL中CD34阳性表达(15.6%)明显低于My-ALL(24.3%)。139例ALL患儿中,82例表达HLA-DR。CD10、CD34、HLA-DR在标危、中危、高危型ALL中的表达差异有统计学意义。My+ALL组性别、出血发生率与My-ALL组比较差异有统计学意义(P<0.05)。结论免疫分型可正确区分儿童ALL的来源。CD10、CD34、HLA-DR抗原表达与ALL的临床分型有关。Objective To study the immunophenotype and its relationship with clinical characteristics in children with acute lymphoblastic leukemia（ALL）. Methods Bone marrow or blood samples（2-3 mL） with heparin anticoagulation from 139 children with ALL were obtained,and immunophenotypes were identified by flow cytometry. Results In 139 ALL children,there were 103 cases（74.1%） of B-ALL,24 cases（17.3%） of T-ALL,12 cases of T/B biphenotypic（8.6% of T/BALL）.In the 103 children with B-ALL,CD19（90.3%）,CD10（83.5%） and CD20（27.2%） were expressed as major antigens.In the 24 children with T-ALL,the major antigens were CD3（79.2%）,CD7（66.7%） and CD5（33.3%）.In the 12 children with B/T-ALL,T-lymphoid antigens included CD7（50.0%） and CD5（41.7%）,while the B-lymphoid antigens included CD19（50.0%） and CD10（33.3%）.Of the 139 children with ALL,32 cases（23.0%） showed myeloid antigen expression（My＋ ALL） and the main expression antigens were CD13,CD33,CD14 and MPO.CD34 was expressed in 31 cases.CD34-positive expression（15.6%） in My＋ ALL children was significantly lower than in My-ALL children（24.3%）.HLA-DR was expressed in 82 of the 139 ALL children.The expression of CD10,CD34 and HLA-DR in the standard-risk,medium risk,high-risk ALL children was significantly different.There were significant differences in gender and incidence of bleeding between the My＋ ALL and My-ALL groups（P0.05）. Conclusions Immunetyping can differentiate the sources of leukemic cells.The expression of CD10,CD34 and HLA-DR antigen is related to the clinical classification of ALL.

关 键 词：免疫表型 急性淋巴细胞白血病 儿童 

分 类 号：R733.71[医药卫生—肿瘤]