111例儿童急性淋巴细胞白血病免疫表型的特点分析

Characteristics of acute lymphocytic leukemia immunophenotype in 111 children

目的探讨儿童急性淋巴细胞白血病（ALL）免疫表型特征和诊断价值。方法应用直接免疫荧光标记以CD45／SSC双参数散点图设门法对111例初治儿童ALL行流式细胞术分析，并探讨形态学分型与免疫分型的关系。结果本组ALL免疫表型特点：①B系ALL 81例（73．0％），T系ALL16例（14．4％），B／T-ALL14例（12．6％）；②伴髓系抗原表达者（My^＋-ALL）25例（22．5％）；③FAB分型L1型59例（53．2％），12型47例（42．3％），13型2例（1．8％，I型早前B型和成熟B型各1例）。急性粒细胞白血病（M2a）l例（0．9％，为I型早期前B型ALL），形态学无法分类2例（均为Ⅱ型早前B型ALL）。结论免疫分型有助于明确白血病性质，是儿童ALL诊断的必要手段。

Objective To study the characteristics of child acute lymphocytic leukemia （ALL） immunophenotype and evaluate its diagnosis value. Methods Direct immunofluorescence staining and CD45/Side Scatter （ SSC） gating of flow cytometry were used for immunophenotyping in 111 cases of child ALL. The relation of morphology and immunology classification was analyzed. Results Three categories could be identified,including 81 cases （ 73.0% ） of B lineage ALL, 16 cases （ 14.4% ） of T lineage ALL and 14 cases （12.6% ） of B/T lineage ALL. There were 25 cases （ 22.5% ） of ALL expressing myeloid-associated antigens. According to the FAB Morphology classification,59 cases （53.2%） of L1 type, and 47 cases （42.3% ）of L2 type were diagnosed. The two cases （ 1.8% ） of L3 type were classified as one case of null-ALL and one case of B-ALL. One case （0.9% ） of acute myeloblastic leukemia （ AML-M2a） was identified as null-ALL. The two cases that could not be diagnosed by FAB classification were c-ALL. Conclusion The immunophenotyping helps to identify the character of leukemia with an important value in diagnosis of child ALL.