急性淋巴细胞性白血病跨系表达方式研究

Pattern of Cross-Lineage Expression in Acute Lymphoblastic Leukemia

目的利用三色流式细胞术对急性淋巴细胞白血病(ALL)免疫表型跨系表达进行研究。方法采用CD45/SSC双参数散点图设门方法对135例ALL(111例B-ALL,24例T-ALL)患者幼稚细胞表面及胞质内分化抗原进行分析。结果在ALL中,髓系抗原(M)表达64%,T和B亚型中髓系抗原表达差异无显著性意义(P>0.05),其中CD13表达最为常见(40%),其次是CD33(37%)、CD11b(20%)和CD15(16%),CD13和CD33在CD34+病例中的表达均高于CD34-病例。B-ALL中,T系抗原CD4、CD2和CD7分别在19例、2例和2例中表达,CD4+和CD7+病例通常共表达CD13和(或)CD33;T-ALL中2例CD19表达者均伴CD13/CD33表达。结论ALL伴髓系表达的频率较高(B+M+,T+M+),偶尔出现B系,T系和髓系共表达的表型(B+T+M+),B系T系共表达但不伴髓系表达的表型(B+T+M-)极少,跨系表达多存在各未成熟的阶段,髓系抗原表达与干细胞表面标志CD34有一定的联系。

Objective To study the cross-lineage expression of acute lymphoblastic leukemia （ALL） with the use of multiparameter flow cytometry in the immunophenotype of ALL. Methods Multiparameter flow cytometry and CD45/SSC gating were used to analyze the surface and cytoplasmic antigen expression in 135 cases of ALL （111 cases of B-ALL and 24 cases of T-ALL）. Results In whole ALL, the expression of myeloid antigens occurred in 64 % of the cases, and the expression frequency had no significant tendency in T and B subtypes （P〉0.05）. The expression rate of CD13 was highest （40 %）, followed by CD33 （37 %）, CD11b （20 %） and CD15 （16 %）. CD13 and CD33 expression were more frequent in CD34^＋ cases than in CD34^- cases. In B-ALL, T-cell antigen CD4, CD2 and CD7 were seen in 19, 2, and 2 cases, respectively, and CD4^＋ and CD7^＋ cases commonly expressed CD13 and/or CD33 （CD13/CD33）. In T-ALL, B-cell antigen CD19 was found in 2 cases with CD13/CD33. Conclusion ALL cells frequently express B^＋ M^＋ , T^＋ M^＋ , and occasionally B^＋ T^＋ M^＋ phenotype, but B^＋ T^＋ M^- phenotype is extremely rare. Cross-lineage expression mostly exists in the immature stages, and myeloid antigens are associated closely with the presence of stem-cell antigen CD34.