急性白血病免疫分型中系列相关抗体的敏感性和特异性研究  

Study on the sensitivity and the specificity of the lineage related monoclonal antibodies in immunophenotyping of acute leukemia

作　　者：吴铭[1] 金鸽[1] 陈晓琳[1] 张新友[1] 徐肇明[1] 

机构地区：[1]暨南大学医学院第二附属医院深圳市人民医院血液科,深圳518001

出　　处：《临床血液学杂志》2004年第2期101-104,共4页Journal of Clinical Hematology

摘　　要：目的 :确定急性白血病免疫分型中系列相关抗体的敏感性和特异性。方法 :应用StJude研究医院的急性白血病免疫分型方案对 6 3例急性白血病患者进行了流式细胞术分型。结果 :B系列急性淋巴细胞白血病(B ALL)敏感性最高的单克隆抗体 (抗体 )是CD19[10 0 % (2 2 / 2 2 ) ],而特异性最高的是CD79a[96 .7% (2 9/ 30 ) ]。CD79a敏感性 (95 .0 % )和特异性均很高 ,在所有B细胞系列相关抗体中确定系列来源的准确性最高 [96 % (4 8/5 0 ) ]。在T ALL ,敏感性最高的抗体是CD7[10 0 % (14 / 14 ) ]和CyCD3[10 0 % (12 / 12 ) ],特异性最高的是CD5[(10 0 % (4 5 / 4 5 ) ]和CyCD3[97.7% (4 2 / 4 3) ];CD7、CyCD3和CD5在B ALL均无假阳性 ;在AML的假阳性分别是 [12 % (3/ 2 5 ) ]、[4 .3% (1/ 2 3) ]和 0 / 2 4 ;但CD5的敏感性仅 [85 .7% (12 / 14 ) ];CD3的敏感性 [6 1.5 % (8/ 13) ]和特异性 [88.6 % (39/ 4 4 ) ]均明显低于上述抗体。综合来看 ,CyCD3敏感性和特异性均很高 ,在所有T细胞系列相关抗体中确定系列来源的准确性最高 [98.2 % (5 4 / 5 5 ) ]。在AML ,MPO的敏感性和特异性最高 [10 0 % (2 3/ 2 3) ]和 [92 .9% (2 6 / 2 8) ],而CD13和CD33的敏感性仅在 6 1.5 %和 76 .9% ,特异性仅为 6 8.8%和 75 .0 %。Objective:To evaluate the sensitivity and specificity of the lineage related monoclonal antibodies in immunophenotyping of acute leukemia.Method:According to the acute leukemia immunophenotyping protocol suggested by St Jude study hospital, 63 patients with acute leukemia were studied with flow cytometry.Result:We found that the CD19 had the top degree of sensitivity, 100%(22/22),in the patients with B-lineage acute lymphoblastic leukemia(B-lineage ALL) while the CD79a had the top of specificity in B-lineage ALL ( 96.7%,29/30). As the results, the CD79a had the top of accuracy, 96% or 48/50, for the its high sensitivity and specificity in B-lineage ALL. In the patients with T-lineage ALL, both CD7 and CyCD3 had the highest sensitivity(100%, 14/14 and 100%, 12/12) while CD5 had the highest specificity(100%, 45/45) and a relative low sensitivity ( 85.7%). Meanwhile, CyCD3 had very high specificity( 97.7%, 42/43). No false positive was detected with the CD7, CD5 and CyCD3 in the patients with B-lineage ALL. On the other hand, CD3 had both low degree of sensitivity and specificity( 61.5% and 81.6%). So the CyCD3 had the top accuracy in determining of T-lineage ALL( 98.2%, 54/55). In the patients with AML, only MPO showed both high degree of sensitivity and specificity, 100%, 23/23 and 92.9%, 26/28; Unfortunately, we did not have got satisfactory results both in CD13 and CD33 which had low sensitivity( 61.5% and 76.9%) and low specificity( 68.8% and 75%).Conclusion:With the immunophenotyping protocol suggested by St Jude hospital, the high sensitivity and specificity of immunophenotyping have been gained in the 63 patients with B-lineage ALL and T-lineage ALL. However, in the patients with AML, only the MPO showed high sensitivity and specificity while the CD13 and the CD33 failed to do well.

关 键 词：白血病 急性 免疫分型 流式细胞术 

分 类 号：R733.71[医药卫生—肿瘤]