儿童急性白血病形态学免疫学和细胞遗传学的分型诊断  

Classification of childhood acute leukemia according to morphology、immunology and cytogenetics

作　　者：柴忆欢[1] 徐杰[1] 何海龙[1] 王易[1] 李捷[1] 王津媛[1] 李祯萍[1] 彭惠兰[1] 朱玲琍[1] 

机构地区：[1]苏州医学院附属儿童医院血液科,江苏苏州215003

出　　处：《临床血液学杂志》2001年第2期62-64,共3页Journal of Clinical Hematology

摘　　要：目的 :准确地进行儿童急性白血病 (AL )的诊断分型 ,提高初诊患儿的诊断符合率。方法 :采用形态学、免疫学和细胞遗传学 (MIC)相结合的诊断方法 ,分析了 110例初诊为 AL的患儿。结果 :形态学与 MIC分型诊断符合率为 88.2 % ;急性淋巴细胞性白血病 (AL L)免疫分型诊断符合率为 92 .2 % ;而急性髓细胞性白血病(AML)仅为 6 2 .9%。8/ 35例 AML 表达淋系抗原 (1y+ - AML) ,12 / 5 9例 AL L 表达髓系抗原 (My+ - AML) ;11/ 110例为杂合性白血病。染色体核型异常检出率为 6 3.6 %。t(8;2 1)易位见于 (13/ 2 1例 ) M2 ;t(7;11)易位见于 1例M2 ;t(15 ;17)易位见于 (2 / 5例 ) M3;t(9;2 2 )和 t(4 ;11)易位见于 (8/ 6 4例 ) AL L。结论 :运用 MIC诊断分型方法能提高儿童 AL 的诊断率 ,为 ALObjective:To establish more acurate criteria for diagnosis of acute leukemia(AL) with children.Method:One hundred and ten cases diagnosed initialy as AL were analyzed with morphology、immunology and cytogenetics(MIC).Result:The conformity rate of cytomorphologic classification with MIC classification was 88.2 %. For ALL, the conformity rate of immunologic classification with MIC classification was 92.2 %, but it was only 62.9 % for AML. Of the 59 ALL, 12 expressed myeloid lineage-associated antigens and 7 0f 35 AML expressed lymphoid lineage associated antigens. Eleven cases were diagnosed as hybrid acute leukemia according to Catovsky criterion. 63.6 % of the patients in this group showed abnormality in cytogenetics. Typical t(8;21)or its varicants was found in 13/21 cases of M 2; t(7;11)in one case of M 2;t(15;17)in 2/5 cases o f M3; t(9;22) and t(4;11)in 8/64 cases of ALL.Conclusion:It is showed that MIC classification is more helpful for diagnosis of AL, and provided an experimental evidence for personalized treatment and evaluated prognosis with AL.

关 键 词：急性白血病 儿童 细胞遗传学 形态学 免疫学 细胞遗传学 诊断 

分 类 号：R733.71[医药卫生—肿瘤]