65例急性白血病形态学、免疫学和细胞遗传学分型诊断

THE MIC CLASSIFICATION OF SIXTY-FIVE CASES OF ACUTE LEUKEMIA

对65例急性白血病(AL)进行了形态学、免疫学和细胞遗传学综合分型,其中ALL41例,包括B系ALL21例、T系ALL18例、T/B杂合型2例;ANLL19例中具有粒或单核系免疫表型者11例,8例结合形态学分型与核型分析定为ANLL;另有5例免疫表型及核型等不具有亚型特异性,暂定为急性未定型白血病。检出的特异性染色体异常包括ph、6q^-、12p^-、t(8;21)、t(15;17)、inv(3q)等。形态学检查是AL诊断分型的基本方法,但单纯依靠形态学诊断可能造成分型的偏差;免疫分型有助于ALL的正确诊断与分型,是对ALL形态学诊断的有力补充,而对ANLL的分型目前尚有局限性;核型分析对AL尤其是ANLL的分型诊断有重要意义。

Sixty-five cases of acute leukemia(AL)were diagnosed and classified with morphologic,immunologic and cytogenetic combing method. Forty-one cases were ALL,whicn included 21 cases of B lineage ALL,18 cases of T lineage ALL,and 2 cases of T/B hybrid ALL.Nineteen cases were ANLL,of which 11 were revealed to have granulocytic or monocytic lineage phenotypes,and the rest 8 cases were classified as ANLL according to the morphologic and cytogenetic studies.As for the rest five cases, diagnosis were made only according to the morphologic findings,because of lacking specific immunologic markers or karyotype.The following specific chromosomal abnormalities were found:ph,6q^-,12p^-,t(8;21),t(15; 17),inv(3q)etc.The results indicate:1,the morphologic classification is a principal and basic method for AL diagnosis,but it has certain degree of misclassification,due to the method itself;2,immunophenotyping is a useful method for correct diagnosis and classification of ALL,but its diag- nostic value for ANLL is limited;3,cytogenetic analysis is of important value for diagnosis and classification of AL,especially ANLL.