MIC分型评价成人急-性髓系白血病中的淋系抗原表达

Evaluation of the lymphocytic antigen expression in adult acute myeloid leukemia cells with MIC classification

目的:研究成人急性髓系白血病(acute myeloid leukemia,AML)中淋系抗原的表达及其与预后的关系。方法:对275例成人AML进行细胞形态学、流式细胞免疫表型分析和染色体细胞遗传学(MIC)分型实验研究并对其中的64例M2进行临床治疗结果观察研究。结果:①AML淋系抗原阳性率31．3％,其中t(8;21)者为48．3％,无t(8;21)者为26．5％(P< 0．001)。②CD19+在t(8;21)中占38．3％,无t(8;21)中占1．9％(P<0．001);而其他淋系抗原两组比较均为P>0．05．③治疗结果(CR率):t(8;21)和无t(8;21)M2分别为66．7％和41．9％,CD19+和CD19-M2分别为76．5％和46．8％,CD19+／t(8; 21)和CD19-／无t(8;21)分别为80．0％和41．4％,以上均为P<0．05。而CD19-／t(8;21)和CD19+／无t(8;21)分别为55．6％和50．0％(P>0．05)。结论:成人AML中淋系抗原表达与核型密切相关,t(8;21)AML高表达CD19。t(8;21)和CD19都是M2预后好的标志之一。

Objective：To study the lymphocytic antigen expression in adult acute myeloid leukemia （AMID and its relationship with clinical prognosis. Methods： The morphologic, immunologic, and cytogenetic （MIC） classifications of lymphocytic antigen expression were performed on 275 adult AML patients. We observed the clinical therapeutic effects of 64 cases of AML/M2 and correlated with MIC parameters. Results： ①The positive rate of lymphocytic antigen in AML was 31.3%. t（8;21）/AML was 48.3% and non t（8;21）/AML was 26. 5% （P〈0.001）. ②CD19^＋ positive rate was 38.3% in t（8;21）/AML and 1.9 % in non t（8;21）/AML, respectively （P〈0. 001）. There was no significant difference in the expression of other lymphocytic antigen between the two groups （P〉0.05）. ③The complete remission （CR） rates of t（8;21）/M2 and non t（8;21）/M2 were 66.7% and 41.9%, respectively （P-%0.05）. TheCR rates of CD19^＋/M2 and CD19^＋-/M2 were 76.5% and 46.8%, respectively （P 〈0.05）. TheCR rates of CD19^＋/t（8;21）/M2 and CD19^＋/non t（8;21）/M2 patients were 80.0% and 41. 4% ,respectively （P〈0.05）. But the CR rates of CD19^＋/t（8;21）/M2 and CD19^＋/non t（8;21）/M2 patients was 55.6% and 50.0%, respec tively （P〉0.05）. Conclusion： Lymphocytic antigen expression in adult AML closely correlated with nuclear type. The expression of CD19 was higher in t（8;21）/AML. Both CD19 and t（8;21） indicate good prognosis of M2.