儿童急性白血病免疫分型及其临床意义

ANALYSIS OF IMMUNOPHENOTYPE OF ACUTE LEUKEMIA IN CHILDREN

目的探讨儿童急性白血病(AL)抗原表达规律及其临床意义。方法采用流式细胞术检测46例儿童AL的免疫表型。结果46例AL中,急性淋巴细胞白血病(ALL)30例,急性髓细胞白血病(AML)10例,杂合型6例。30例ALL中,T系ALL 4例(13.3%),B系ALL 26例(86.7%)。ALL中3例(10%)有髓系抗原表达,以CD33阳性最常见;AML中4例(40%)有淋系抗原表达,以CD7阳性率最高。儿童AML淋系抗原表达阳性率高于儿童ALL髓系抗原表达(χ2=4.32,P<0.05)。B系ALL中CD34阳性率为56.5%。AML中CD34的表达频率为40.0%,其中M2的CD34阳性率为66.6%,高于其他AML病儿的CD34阳性率(2χ=5.42,P<0.05)。结论应用免疫分型可以较好地分析每例白血病病儿,尤其是对于混合型白血病及抗原交叉表达者更有意义。

Objective To analyze the immunophenotype of acute leukemia （AL） in children and explore its clinical significance. Methods The immunophenotype in 46 children with AL wase detected by flow cytometry. Results Of the 46 cases, 30 were acute lymphoblastic leukemia （ALL）, 10 were acute myelogenous leukemia （AML） and six were mixed leukemia. Among the 30 cases of ALL, four were T-lineage ALL （T-ALL） （13.3%） and 26 were B-lineage ALL （B-ALL） （86.7%）. The myeloid antigen expression was noted in 10% of ALL with CD33 the most commonly expressed. Among the AML, the lymphoid antigen expression was positive in 40 %, with CD7 most commonly expressed. The frequency of the lymphoid antigen expression in AML was higher than that of the myeloid antigen expression in ALL （P〈0.05）. The positive CD34 of the B-ALL was found in 56.5% of the cases, and that of the AML in 40.0 %, in which, those of M2 AML cases was 66.6 %, higher than those of the cases with other types of AML （28.6%） （P%0.05）. Conclusion With the immunophenotyping, every acute leukemia case can be better analyzed, especially for those with mixed leukemia and cross-lineage expression leukemia.