慢性粒细胞白血病不同病期形态学和免疫学诊断分型  

Morphological and immunological diagnosis of chronic myeloid leukemia in different phases

作　　者：李玲[1] 王蕊[1] 钟笛[1] 陈瑢[1] 迪丽娜孜.阿不来提 曲建华[1] 郭新红[1] 郝建萍[1] 温丙昭[1] 

机构地区：[1]新疆医科大学第一附属医院血液科,新疆乌鲁木齐830054

出　　处：《新疆医科大学学报》2003年第4期306-309,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区科技厅自然科学基金资助项目(2 0 0 12 110 2 );新疆医科大学第一附属医院科研基金资助项目(2 0 0 1-YFY-0 5)

摘　　要：目的 :探讨慢性粒细胞性白血病 ( CML )不同病期患者的形态学和免疫学表型联合诊断分型。方法 :应用间接免疫荧光法对 80例 CML 患者不同病期骨髓单个核细胞 ( MNC)进行形态学和免疫表型检测。 结果:CML慢性期、加速期、急变期 CD34 及 HL A- DR抗原表达阳性率分别为 3.6 %和 31% ,36 %和 73% ,6 2 %和 10 0 % ,慢性期与急变期相比差异有统计学意义 ( P <0 .0 5 ) ;CD1 5随疾病进展趋于递减 ,尤其在急变期明显低于慢性期和加速期( P均 <0 .0 5 ) ;急变期 13例中 11例表达 CD9+;部分急变期患者原始细胞无特征 ,既有淋系又有髓系特点 ;其免疫表型和形态学诊断符合率为 77%。结论:在急变类型和不同病期进展中显示出膜标记有决定性意义 ,而形态学和细胞化学方法也有免疫表型不可替代的作用。形态学、细胞化学 +免疫表型联合诊断可达到互补。Objective: To study the combination of morphological and immunophenotype diagnosis in chronic myeloid leukemia at different phases. Methods: Indirect immunofluorescence assay was used to detect the immunophenotype of bone marrow mononuclear cells in 80 CML patients. Results: The expression rates of CD 34 and HLA DR were 3.6% and 31% in the chronic phase, 36% and 73% in acceleration phase, 62% and 100% in blastic phase, respectively. Both CD 34 and HLA DR were significantly higher in blastic phase than chronic phase (P<0.05). CD 15 \++ cells tend to decrease with the progression of the disease and were especially significantly lower in blastic phase than that in chronic and acceleratad phase (P<0.05). CD\-9\++ cells were detected in 11/13 patients in blastic phase. The diagnostic coordination rate between immunophenotype and morphology was 77% in 13 CML patients in blastic phase. Blast cells expressed both lymphoid and myeloid lineage antigens in part of blastic patients. Conclusion: The membrane markers have determinant significance to identify the type of blast crisis and progression of the disease in different phases,but morphology and cytochemistry has its important role which can't be replaced by immunophenotyping. The combination of morphology、 cytochemistry and immunophenotyping can complement each other in the diagnosis of CML.

关 键 词：慢性粒细胞性白血病 形态学 免疫学 急变 

分 类 号：R733.71[医药卫生—肿瘤] R730.3[医药卫生—临床医学]