106例成人急性白血病流式细胞术免疫分型分析  

Immunophenotyping of106adult patients with acute leukemia by flow cytometry

作　　者：徐兵[1] 胡成[2] 缪旭东[2] 吴燕虹[2] 易正山[1] 杨艺[1] 孟凡义[1] 冯茹[1] 刘启发[1] 刘晓力[1] 郑维杨[1] 

机构地区：[1]第一军医大学南方医院血液科,广东广州510515 [2]第一军医大学学员一旅,广东广州510515

出　　处：《第一军医大学学报》2003年第10期1043-1046,共4页Journal of First Military Medical University

基　　金：广东省重点科技攻关项目(B30202-10)~~

摘　　要：目的研究成人急性白血病免疫分型及与预后的关系。方法以CD45/SSC双参数散点图设门,采用流式细胞术检测106例成人急性白血病患者免疫分型情况。结果(1)71例急性髓系白血病(AML)患者主要表达CD13、CD33、HLA-DR、CD34和CD117抗原,23.9%的AML患者伴有淋系抗原表达,15.5%的AML病人伴有CD56抗原的表达。(2)29例急性淋巴细胞白血病(ALL)患者主要表达HLA-DR、CD10、CD19、CD34和CD7,34.5%的ALL患者伴有髓系抗原的表达。(3)伴有淋系抗原表达的AML患者化疗完全缓解(CR)率为52.9%(9/17),显著低于未伴有淋系抗原表达的AML病人(77.8%)(P<0.05);伴有髓系抗原表达的ALL患者化疗后CR率为70.0%,而未伴有髓系抗原表达的ALL患者CR为94.7%,两者差异无显著性(P>0.05);CD56+AML患者化疗后CR率仅36.4%,显著低于CD56- AML患者(78.3%)(P<0.025);CD34+ AML患者化疗后CR率为56.0%,显著低于CD34- AML患者(80.4%)(P<0.05)。结论采用CD45和SSC双标记设门可较好地排除正常骨髓细胞的影响,较准确地反映病人的免疫学分型;伴淋巴系抗原表达的AML、CD56+ AML及CD34+ AML化疗后CR率低,预后差。Objective To study the immunophenotyping of adult patients with acute leukemia and its association with the prognosis. Methods Immunophenotyping was performed in 106 adult patients with acute leukemia by three-color flow cytometry analysis using CD34/SSC gating. Results The antigens expressed in 71 patients with acute myeloid leukemia (AML) were mainly CD13, CD33, HLA-DR, CD34 and CD117. Lymphoid antigen expression was identified in 23.9% adult AML patients and CD56 antigen expression in 15.5% of the AML patients. In 29 patients with acute lymphoblastic leukemia (ALL), the expressed antigens were mainly HLA-DR, CD10, CD19, CD34 and CD7, and 34.5% of these patients were found to be positive for myeloid antigen expression. Complete remission (CR) rate in AML patients with lymphoid antigen expression after chemotherapy was lower than that in AML patients without lymphoid antigen expression (52.9% vs77.8%, P<0.05), and no significant impact was noted of myeloid antigen expression in ALL on the CR of the patients (70.0% vs94.7%, P>0.05). The CR rate in AML with CD56 antigen expression was lower than that in AML without CD56 expression (36.4% vs78.3%, P<0.025), and the CR rate in CD34 + AML was lower than that in CD34 - AML (56.0% vs80.4%, P<0.05). Conclusions Gating of CD45/SSC can eliminate the interference of normal cells to render more reliable immunophenotyping results. The expressions of CD56 + , CD34 + , lymphoid antigen in adult AML patients, who have lower CR rate, often signify poor prognosis.

关 键 词：成人 急性白血病 流式细胞术 免疫分型 预后 

分 类 号：R733.7[医药卫生—肿瘤]