分化抗原与小儿急性淋巴细胞白血病的临床关系

The relationship between differentiation anitigen and childhood acute lymphoblastic leukemia

目的：为了探讨免疫分型与临床表现的关系，为该病型的诊断和分型的治疗奠定基础。方法：将取自患者骨髓标本处理后依次与１０种识别人白细胞分化抗原的单克隆抗体经ＡＰＡＡＰ方法反应，根据实验结果将３３例急淋分为Ｔ－ＡＬＬ和非Ｔ－ＡＬＬ以及各自的亚型。在所有病例中，将ＣＤ７＋与ＣＤ７－的急淋作为一组对比，在非Ｔ－ＡＬＬ中，将ＣＤ１０＋与ＣＤ１０－的急淋作为一组对比，用χ２检验、ｔ检验统计方法分别比较和分析这些不同的免疫表型之间的临床各指标的差异。结果：ＣＤ７＋的急淋其外周血白细胞均数明显高于ＣＤ７－的急淋（Ｐ＜００１），出血情况和严重脏器侵润都较多（Ｐ＜００５，Ｐ＜００５），且达到缓解的时间较长（Ｐ＜００１）。ＣＤ１０＋的非Ｔ－ＡＬＬ达到缓解的时间明显短于ＣＤ１０－的非Ｔ－ＡＬＬ（Ｐ＜００１）。

Purpose: Immunophenotype are used in 33 cases of childhood acute lymphoblastic (ALL) by morphology in order to make an inqury into connection between immunophenotype and clinical manifestation of ALL, which may lay a foundation for diagnose and treatment of ALL. Method: We maked some smears from bone marrow, after being treated through certain procedure, react on 10 kinds of monoclonal antibodies detecting antigens expressed by human white cells in turn with method of APAAP. According to results above all, 33 cases of ALL are divided into T-ALL and non T-ALL both of which consist of several subgroups. One group expressing CD 7 is compared with another group of absence of CD 7 in all cases as one group expresing CD 10 is with its opponent in non T-ALL. We use χ2 - test and t- test statisticaly to compare and analyse respectively difference between different immunophenotype in each clinical feature. Results: ALL expressing CD 7 is significantly different from those ALL in which CD 7 is absent in the average of leukocyte counts (P<0.01), bleeding (P<0.05), infiltration of organ (P<0.05) and time reaching complete remission (P<0.01),in addition, time at which nonT-ALL expressing CD 10 get complete remission is shorter than its opponent (P<0.01). Conclusions: This research has pointed out that analysis of white cell surface markers have a certurnly clinical distinguishing significance.