急性白血病的诊断分型及预后判断  

Classification and Prognosis on Acute Leukemia

作　　者：唐亚辉[1] 马葵[1] 李次芬[2] 殷宗建[2] 袁淑雯 杨平地[1] 向丹[1] 

机构地区：[1]海军总医院血液实验室,北京100037 [2]解放军总医院血液科,北京100073 [3]航天部中心医院血液科,北京100039

出　　处：《海军总医院学报》2002年第2期81-84,共4页Journal of Naval General Hospital of PLA

摘　　要：目的　采用形态学、免疫学、细胞遗传学和分子生物学分型体系对 10 2例急性白血病进行综合分型。方法　按照FAB标准进行形态学分型 ;运用间接免疫荧光法标记活细胞膜表面分化抗原确定细胞属性 ;采用 2 4h培养法或直接法制备染色体标本 ;用PCR方法检测融合基因。结果　形态学分型、免疫学分型与形态学、免疫学、细胞遗传学和分子生物学体系分型符合率分别为 91 2 %和 98 0 % ;16 6 7型急性髓细胞白血病表达淋系抗原 ,预后好 ;6 2 6例急性淋巴细胞白血病表达髓系抗原 ,预后差。染色体异常 (6 2 80例 )检出率为77 5 % ;其中 (44 6 2例 ) 71 0 %为特异性异常。融合基因的检查也具有特异性的分子标志。结论　形态学、免疫学、细胞遗传学和分子生物学体系分型可提高急性白血病的分型准确性 ,具有指导临床 ,提示预后的意义。Objective 102 cases of acute leukemia (AL) were diagnosed and have prognosis. Methods Classified based on morphologic,immunologic, cytogenetics and molecular biology (MICM) features. Result The conformity rate of cytomorphologic/cytochemical and immunologic classfication with MICM classification was 91 2% and 98.0%. Of the 67 AML, 16 expressed lymphoid lineage associated antigens with favourable prognosis and 6 of 26 ALL expressed myeloid lineage associated antigens with unfavourable result. The chromosome aberrations were found in 62/80 case (77.5%), of them 44/62 cases (71.0%) showed characteristic abnormalities. The fusion gene, including AML1/ETO, PML/RAR α and CBFB/MYHⅡ etc, is the reliable molecular target in acute leukemia. Conclusion The MICM system is a more objective and accurate protocal in classification of acute leukemia, and it has more important clinical significance in indication of the treatment and prognosis.\;

关 键 词：白血病 诊断 细胞遗传学 融合基因 

分 类 号：R733.7[医药卫生—肿瘤]