流式免疫分型联合骨髓细胞形态学分型在急性白血病诊断中的应用  

Application of flow immunotyping combined with bone marrow cell morphological typing in diagnosis of acute leukemia

作　　者：李振燕[1] Li Zhenyan(Department of Clinical Laboratory,Jilin Central Hospital,Jilin 132001,Jilin,China)

机构地区：[1]吉林市中心医院检验科,吉林吉林132001

出　　处：《实用检验医师杂志》2022年第2期133-136,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的分析流式免疫分型联合骨髓细胞形态学分型在急性白血病诊断中的应用。方法选择吉林市中心医院2020年1月—2021年12月收治的70例急性白血病患者作为研究对象。采用流式细胞术对所有患者进行流式免疫分型检测,采用细胞化学染色试剂盒进行骨髓细胞形态学分型检测;检测后对两种分型方式的最终结果进行分析,比较FAB形态学分型与免疫分型结果,并详细记录急性淋巴细胞白血病(ALL)患者和急性髓系白血病(AML)患者的免疫表型表达水平的差异。结果①FAB形态学分型诊断结果显示,70例急性白血病患者中56例为AML,14例为ALL。②56例AML患者的免疫表型检测结果显示,cMPO表达率最高〔98.21%(55/56)〕,之后依次为CD13〔80.36%(45/56)〕、CD117〔71.43%(40/56)〕、CD33〔67.86%(38/56)〕、CD15〔64.29%(36/56)〕、HLA-DR〔62.50%(35/56)〕、CD34〔57.14%(32/56)〕、CD64〔50.00%(28/56)〕、CD38〔46.43%(26/56)〕、CD14〔39.29%(22/56)〕、CD11b〔32.14%(18/56)〕、CD19〔10.71%(6/56)〕。③14例ALL患者的免疫表型检测结果显示,CD19 cMPO表达率最高〔85.71%(12/14)〕,之后依次为cCD22与CD23〔均为78.57%(11/14)〕、cCD79a〔71.43%(10/14)〕、HLA-DR〔64.29%(9/14)〕、CD10〔57.14%(8/14)〕、CD34〔42.86%(6/14)〕、TdT〔28.57%(4/14)〕、CD2〔14.29%(2/14)〕、CD5〔7.14%(1/14)〕。结论流式免疫分型与骨髓细胞形态学分型联合应用在诊断急性白血病中可以优势互补,取得更好的效果,同时对于B细胞、T细胞系及FAB形态学无法分型的急性白血病患者可借助免疫分型加以诊断,监测微小残留病变,对开展个体化治疗进行指导。Objective To analyze the application of flow immunotyping combined with bone marrow cell morphological typing in diagnosis of acute leukemia.Methods The 70 patients with acute leukemia treated in Jilin Central Hospital from January 2020 to December 2021 were selected as the research objects.All patients were detected by flow immunotyping and cytochemical staining kit for bone marrow cell morphological typing and flow immunotyping.The final results of the two methods were analyzed,and the results of FAB morphological typing and immunotyping were compared.The expression of immunophenotype in patients with acute myeloid leukemia(AML)and acute lymphoblastic leukemia(ALL)were recorded in detail.Results①The diagnosis results of FAB morphological typing were as follows.②Among 70 patients with acute leukemia,56 cases were AML,14 cases were ALL.The immunophenotypic results of 56 patients with AML showed that the expression rate of cMPO was the highest[98.21%(55/56)],followed by CD13[80.36%(45/56)],CD117[71.43%(40/56)],CD33[67.86%(38/56)],CD15[64.29%(36/56)],HLA-DR[62.50%(35/56)],CD34[57.14%(32/56)],CD64[50.00%(28/56)],CD38[46.43%(26/56)],CD14[39.29%(22/56)],CD11b[32.14%(18/56)]and CD19[10.71%(6/56)].③The immunophenotypic results of 14 patients with ALL showed that the expression rate of CD19 cMPO was the highest[85.71%(12/14)],followed by CD22 and CD23[both 78.57%(11/14)],cCD79a[71.43%(10/14)],HLA-DR[64.29%(9/14)],CD10[57.14%(8/14)],CD34[42.86%(6/14)],TdT[28.57%(4/14)],CD2[14.29%(2/14)]and CD5[7.14%(1/14)].Conclusions The combined application of flow immunotyping and bone marrow cell morphologicl typing in the diagnosis of acute leukemia can complement each other and achieve better diagnostic results.At the same time,for acute leukemia patients whose B cell,T cell lines and FAB morphology cannot be classified,immune typing can be used to diagnose,monitor minor residual lesions,and guide patients to carry out individualized treatment.

关 键 词：急性白血病 流式免疫分型 骨髓细胞形态学 诊断效果 

分 类 号：R733.71[医药卫生—肿瘤]