急性白血病扫描电镜观察及其临床意义

AN OBSERVATION OF ACUTE LEUKEMIA BY SCANNINGELECTRON MICROSCOPE AND ITS CLINICAL SIGNIFICANCE

用扫描电镜（ＳＥＭ）研究了２６例急性白血病细胞表面形态特征，同时结合光镜形态学（ＦＡＢ）、免疫学和细胞遗传学分型（ＭＩＣ），结果发现，ＳＥＭ可更准确地区分急性淋巴细胞白血病（ＡＬＬ）和急性非淋巴细胞白血病（ＡＮＬＬ）。在ＡＮＬＬ中，白血病粒细胞以表面横嵴为特征，白血病单核细胞以基底宽的膜性皱起为特征，ＳＥＭ观察结果与ＭＩＣ分型符合率为９０．５％。在ＡＬＬ病例中，ＳＥＭ区分其免疫亚型有一定局限性。ＡＮＬＬ的疗效与ＳＥＭ下白血病细胞的分化程度可能相关。

n order to diagnose acute leukemia accurately on morphology,we studied 26 patient;with acute leukemia using scanning electron microscope(SEM)and combined morphological,immunological and cytogenetic(MIC)classification.The results indicated that lymphoblastic and nonlymphoblastic leukemic cells can readily be distinguished under the SEM.Among patients with acute nonlymphoid leukemia(ANLL),myeloblasts and maturing myeloid cells had more raised transverse ridgelike ruffled membrances.The concordance rate between SEM observation and MIC classificatiOn was 90.6%.However,SEM does not appear to contribute in difining the cell type in immunological subtypes of ALL.It was relationship between therapy response and differentiated degree of leukemic cells under the SEM in the patients with ANLL.