35例慢性淋巴细胞白血病MIC研究

Analysis of Immunophenotype(I)、Morphology(M) and Cytogenetics(C) in 35 Cases of Chronic Lymphocytic Leukemia

目的探讨慢性淋巴细胞白血病(CLL)的免疫表型特征并分析免疫表型和细胞形态学及遗传学的关系。方法应用一组系列相关的单克隆抗体射门的三色流式细胞术对35例CLL免疫表型进行检测。以常规R显带及荧光原位杂交(FISH)检测13q14.3(D13S272),11q22(ATM)位点缺失。结果35例CLL中,B-CLL29例,T-CLL4例,CLL/PLL(慢淋-幼淋混合型)2例。35例CLL均表达CD5,其中B-CLL主要CD19+,CD20+,T-CLL主要CD2+,CD3+,CD7+,CD8+,2例CLL/PLL混合型CD5-。细胞形态学显示33例CLL骨髓及外周血中以成熟淋巴细胞增多为主,2例CLL/PLL型,11%<幼淋巴细胞<50%。35例CLL中,13例有细胞遗传学异常,6例为数目异常,涉及三体3、三体12、三体14、三体18;5例为结构异常,2例为复杂异常。对17例CLL的13q14.3(D13S272),11q22(ATM)位点进行FISH检测,结果7例有位点缺失。结论慢性淋巴细胞白血病的诊断和免疫表型、形态学及遗传学分析密切相关。

Objective To research immunophenotypic characteristics in CLL,and its correlation with the cytomorphology and cytoge- netics. Methods Immunophenotyping was performed in 35 cases with CLL by flow cytometry analysis using a panel of monoclonal anti- bodies and CD45/SSC gating. Routine R -banding was performed and sequence specific probes for D13S272（ 13q14.3 ） ,ATM（ 11q23 ） were used to detect del（13q14.3） and del（ 1 lq23 ） by FISH （fluorescence in situ hybridization ）. Results Among 35 cases of CLL , 29 cases＇ were B - lineage CLL, 4 cases were T - lineage CLL, 2 cases were CLL/PLL, 35 cases with CLL were CD5^＋ , and among them B - CLL mainly were CD19^＋ ,CD20^＋ ,T - CLL mainly were CD2^＋ ,CD3^＋ ,CD7 ^＋ ,CD8^＋,2 CLL/PLL were CD5^-. In morphology, in marrow or peripheral were mainly small mature lymphocytes,in CLL/PLL prolymphoeytes exceed 11% and less than 50%. From 35 CLL,13 cases have cytogenetic abnormalities, 6 cases were number aberrations, concerning trisomy 3,12,14 and 18. 5 cases were structural ab- normalities,2 cases were complex abnormalities. Seven cases with del（13q14.3） ,del（ 11q23 ） were detected by two sequence specific probes for D13S272（13q14.3） ,ATM（11q23）. Conclusions The diagnosis of CLL was closely related with immunophenotyping ,morphology and cytogenetics.