27例具有超二倍体的急性淋巴细胞白血病患者的遗传学及免疫表型特征分析  

Genetic and immunophenotypic analysis of 27 acute lymphoblastic leukemia cases with hyperdiploidy

作　　者：孙川[1] 李倩[2] 王菊香[2] 张亚文[3] 王卫[3] 冯亮[3] 张英辉[1] 张诚胜 

机构地区：[1]海南省农垦总医院,海南海口570311 [2]温州医学院附属第二医院,浙江温州325003 [3]吉林油田总医院,吉林松原138000

出　　处：《中国卫生检验杂志》2013年第13期2760-2763,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨27例具有超二倍体的急性淋巴细胞白血病(ALL)患者的遗传学特点、免疫表型特点。方法常规R显带分析核型,三色流式细胞术检测免疫表型变化。结果在统计的77例儿童ALL核型中,高超二倍体17例(22%)。35例成人ALL核型中,高超二倍体2例(5.7%)。高超二倍体在儿童中的比例明显高于成人(P<0.05)。22例具有超二倍体的儿童ALL患者中,高超二倍体17例,16例+21。低超二倍体5例,伴有结构畸变3例。5例具有超二倍体的成人ALL患者中,4例有结构畸变。27例患者免疫表型检测均为B-ALL。4例伴有T淋系抗原表达(14.8%),25例伴有髓系抗原CD13表达(92.6%),其中19例同时表达CD13和CD34(70.4%)。6例复发患者中,4例为低超二倍体,2例为高超二倍体。3例伴CD20表达,2例伴T淋系表达。结论高超二倍体主要见于儿童BALL,以21号染色体增加最多见。具有超二倍体的ALL患者常伴髓系抗原CD13表达,且多和CD34同时表达。超二倍体及免疫表型与ALL的预后相关。Objective To study genetic characteristics and immunophenotypic features in 27 cases of acute lymphoblastic leukemia（ALL） with hyperdiploidy.Methods R-banding karyotype analysis was performed.Immunophenotyping was performed by three-color flow cytometry.Results Among 77 cases of childhood ALL,17 cases（22%） were high hyperdiploidy.Among35 cases of adult ALL,2 cases（5.7%） were high hyperdiploidy.High hyperdiploid proportion in childhood was significantly higher than that in adult（P0.05）.Among 22 cases of childhood ALL,17cases had high hyperdiploidy,of which 16 cases had ＋ 21.Five cases had low hyperdiploidy,of which 3 cases had structural aberrations.Among 5 cases of adult ALL with hyperdiploidy,4 cases had structural aberration.Twenty-seven cases were B-ALL.Four cases were accompanyed by T lymphoid antigen expression（14.8%）,while 25 cases expressed myeloid antigen of CD13（92.6%）,in which 19 cases expressed CD13and CD34 simultaneously（70.4%）.Six cases relapsed,in which 4 cases had low hyperdiploidy,and 2 cases had high hyperdiploidy.Three cases expressed CD20,2 cases expressed T lymphoid antigen.Conclusion High hyperdiploidy mainly existed in childhood B-ALL,involving mostly chromosome 21.Cases of acute lymphoblastic leukemia with hyperdiploidy usually expressed myeloid antigen of CD13 and CD34 simultaneously.Hyperdiploidy and immunophenotype were realated with prognosis of acute lymphoblastic leukemia.

关 键 词：急性淋巴细胞白血病 超二倍体 遗传学 免疫表型 

分 类 号：R733.7[医药卫生—肿瘤]