成人急性淋巴细胞白血病免疫表型的特点分析  

Immunophenotype Analysis of Adult Patients with Acute Lymphoblastic Leukemia

作　　者：王晓雪[1] 王萍萍[1] 梁颖[1] 李艳[1] 颜晓菁[1] 

机构地区：[1]中国医科大学附属第一医院血液科,沈阳110001

出　　处：《中国医科大学学报》2015年第10期904-908,共5页Journal of China Medical University

基　　金：教育部新世纪优秀人才支持计划(NCET-13-1037);辽宁省高等学校优秀人才支持计划(LR2013)

摘　　要：目的探讨成人急性淋巴细胞白血病(ALL)免疫表型的特点和临床意义。方法应用流式细胞术检测57例初诊成人ALL患者的免疫表型,分析其临床特点和意义。结果 B细胞急性淋巴细胞白血病(B-ALL)患者中CD19、CD22表达阳性率明显高于CD10和CD20(P<0.05)。T细胞急性淋巴细胞白血病(T-ALL)中CD7和c CD3表达阳性率高。早期抗原CD34、CD38在各种分型ALL中均高表达。HLA-DR仅在B-ALL中呈较高的阳性表达率。My+-ALL和My--ALL患者比较,基本资料、完全缓解率和复发率均无统计学差异(P>0.05),但My+-ALL患者早期抗原CD34和HLA-DR抗原阳性表达率明显高于My--ALL患者(P<0.05)。细胞遗传学分析提示,核型异常组患者复发率高。高危核型组患者较标危核型组CD20和CD13表达强(P<0.05)。结论成人ALL患者免疫分型及染色体核型有着明显的异质化特点,染色体核型异常患者复发率高,可以为临床医生对ALL进行分层诊断和个体化治疗提供依据。Objective To study the immunophenotype and chromosome karyotype of 57 adult patients with newly-diagnostic acute lymphoblastic leukemia（ALL）. Methods The immunophenotype and chromosome karyotype of 57 adult patients with newly-diagnostic ALL were determined by using flow cytometer and karyotyping,and then the clinical characteristics and significance were analyzed. Results In patients with B cell acute lymphoblastic leukemia（B-ALL）,the expression of CD19 and CD22 were significantly higher than CD10 and CD20（P〈0.05）. The expression of CD7 and CD3 were much higher in patients with T cell acute lymphoblastic leukemia（T-ALL）. As for the early antigen,patients of all subtypes of ALL showed high expression rate of CD34 and CD38. In addition,the HLA-DR was only detected in B-ALL. There was no difference in comparison with clinical characteristics,total rate of CR and rate of relapse between ALL with and without myeloid antigen expression. The expression rate of CD34 and HLA-DR was higher in My＋-ALL（P〈0.05）. The relapse rate was much higher in these patients with abnormal karyotype than other patients（P〈0.05）. Patients with high-risk karyotype showed higher expression rates of CD20 and CD3 than those with standard-risk. Conclusion The immunophenotypes and chromosome karyotypes show obviously heterogeneous features,and the patients with abnormal karyotypes have higher relapse rate. These above mentioned methods are applicable for the diagnosis and individualized treatment of ALL patients.

关 键 词：急性淋巴细胞白血病 免疫分型 流式细胞术 细胞遗传学 

分 类 号：R733.7[医药卫生—肿瘤]