伴有错译抗原表达的急性白血病临床特征研究  

Clinical characteristics of acute leukemia patients with cross-lineage expression

作　　者：钟凌[1] 李焱鑫[1] 黄文芳[1] 

机构地区：[1]四川省人民医院,四川成都610072

出　　处：《国际检验医学杂志》2015年第21期3101-3104,共4页International Journal of Laboratory Medicine

摘　　要：目的研究伴有错译抗原表达的急性白血病(AL)的临床特征。方法采用流式细胞术检测AL白血病细胞免疫表型,根据免疫标记和世界卫生组织分型标准,将错译表达髓系和淋系相关抗原的急性白血病患者进行分组,分析其异质性生物学特征和影响预后的相关因素,以随访观察比较患者生存曲线的差异。结果 320例伴有错译抗原表达的AL患者中,FAB分型以急性髓细胞白血病(AML)-M2、急性淋巴细胞白血病(ALL)-L2、分类不明细胞为主;免疫分型以B系、髓系交叉表达最为多见(176例),其次是T系、髓系交叉表达(131例),B系、T系和髓系三系抗原交叉表达仅10例。在伴有淋系抗原表达的AML(Ly+AML)中,B系抗原以CD19最为常见,T系抗原以CD7最为多见;在伴有髓系抗原交叉表达的ALL(My+ALL)中,以CD33最为常见。45例患者出现髓系抗原与CD56交叉表达;CD7、CD34存在相关性(P<0.05),CD19、CD34存在相关性(P<0.05),9例患者存在CD34、CD7、CD19交叉表达,7例患者存在CD34、CD7、CD56交叉表达。Ly+AML伴重现性染色体异常23例,其中AML伴t(8;21)(q22;q22)、RUNX1-RUNX1T1 11例,AML伴t(15;17)(q22;q11-12)、PML/RARα3例,AML伴骨髓异常嗜酸粒细胞增多inv(16)(p13;q22)、CBFβ/MYH11 6例,AML伴t(9;11)(p22;q23)、MLLT3-MLL 3例。My+ALL伴重现性染色体异常15例,其中B-ALL伴t(9;22)(q34;q11.2)、BCR-ABL1 9例,B-ALL伴t(v;11q23)、MLL重排3例,T-ALL 14q11.2 3例。伴重现性染色体异常的AL患者存在错译抗原表达,Ly+AML患者常错译CD19、CD56、CD2,My+ALL患者常错译CD13、CD33。伴有错译抗原表达的AL患者中,与不伴有淋系抗原表达的AML(Ly-ALL)患者比较,CD7+AML、CD19+AML、CD56+AML患者生存曲线比较差异有统计学意义(P值分为0.01、0.02、0.02),My-ALL患者与CD13/33+ALL患者生存曲线比较差异无统计学意义(P<0.05);CD34表达者较多(96例表达),是对影响患者预后的最主要因素。53例表达CD7,且与CD34存在相关性(P<0.05),也是�Objective To study the clinical characteristics of acute leukemia（AL）patients with cross-lineage antigen expression.Methods Patients were diagnosed and classified by morphology,cytochemistry and immunology assay,and prognostic acting factor were also analyzed.Results According to FAB standards,acute myeloid leukemia（AML）-M2,acute lymphocytic leukemia（ALL）-L2 and no-classified type were common in 320 patients with cross-lineage antigen expression.The immunophenotype with B and myeloid mixed expression was the most common（176cases）,followed by cross expression of antigen T and myeloid（131cases）,and the co-expression of B,T and myeloid antigen was found in only 10 cases.In lymphoid antigenpositive AML（Ly＋AML）,CD19 antigen was the most common among B lineage,CD7 was the most common in T lineage.In myeloid antigen positive ALL（My＋ALL）,CD33 was the most common myeloid antigen.Forty-five cases were with mixed expression of myeloid antigen and CD56 expression.Correlation existed between CD7 and CD34（P〈0.05）,CD19 and CD34（P〈0.05）.There were 9patients with CD34,CD7 and CD19co-expression,7patients with CD34,CD7 and CD56co-express.In Ly＋AML patients,23 cases were with recurrent chromosome abnormality,including 11 cases with t（8;21）（q22;q22）,RUNX1-RUNX1T1,3cases with t（15;17）（q22;q11-12）,PML/RAR,6cases with bone marrow eosinophilia inv（16）（p13;q22）,CBF beta/MYH11,and 3cases with t（9;11）（p22;q23）,MLLT3-MLL.In My＋ALL,15 patients were with recurrent chromosome abnormality,including 9cases of B-ALL with t（9;22）（q34;q11.2）,BCR-ABL1,3cases of B-ALL with t（v;11q23）,MLL rearrangement,and 3cases of T-ALL with 14q11.2.Among the presence of reproducible chromosomal abnormalities in AL,the antigen expression of mistranslation was still with a certain feature：Ly＋AML patients often mistranslated CD19,CD56,CD2,and My＋ALL patients often mistranslated CD13 and CD33.Compared with the lymphoid antigennegative AML（Ly-ALL）group,CD7＋AML group,CD

关 键 词：白血病 急性 错译抗原表达 免疫分型 临床特征 

分 类 号：R733.71[医药卫生—肿瘤]