免疫组织化学在急性白血病骨髓活检中的应用

Application of Immunohistochemistry in the Bone Marrow Biopsy for Acute Leukemia

目的研究MPO、CD68蛋白在急性髓细胞性白血病和TdT、CD20、CD79a、CD3、CD45RO蛋白在急性淋巴细胞性白血病骨髓活检组织中的应用价值。方法应用免疫组化方法检测80例急性白血病患者(分为急骨组和急淋组)的骨髓活检组织中MPO、CD68蛋白和TdT、CD20、CD79a、CD3、CD45RO蛋白的表达水平,并与骨髓细胞涂片诊断对比分析。结果急髓组36例,MPO(+)32例(94.4%),CD68(+)31例(86.1%)。急淋组:(1)T-ALL19例;TdT(+)15例(78.9%)、CD3(+)16例(84.2%)、CD45RO(+)13例(68.4%);(2)B-ALL25例;TdT(+)19例(76%)、CD20(+)16例(64%)、CD79a(+)24例(96%)。MPO和CD79a均为高表达。结论上述免疫组化的阳性表达敏感比较高,与骨髓细胞涂片有较好的一致性,可作为判断急性白血的重要参考指标,具有应用价值。

Objective To study the applied value of the bone marrow biopsy of MPO and CD68 proteins in acute myelocytic leukemia and of TdT,CD20,CD79a,CD3,CD45RO protein in acute lymphocytic leukemia. Methods By means of immunohistochemistry, to detect the expression levels of both MPO, CD68 proteins and TdT, CD20, CD79a, CD3, CD45RO proteins in their bone marrow biopsy tissue of 80 cases of acute leukemia patients that are divided into two groups ：group A with acute myelocytic leukemia and group B with acute lymphocytic leukemia, and to compare them with those of the myelocyte smear diagnosis so as to analyze. Results In group A with 36 cases of acute myelocytic leukemia, 32 cases of their expression levels of MPO（＋） being 94.4% and 31 cases of those of CD68（＋） being 86.1%; while in group B with the rest cases of acute lymphocytic leukemia, （1）19 with T-ALL,in which 15 cases of their TdT （＋） levels being 78.9%, 16 cases of their CD3（＋） levels being 84,2%, 13 cases of their CD45RO（＋） levels being 68.4%; （2） 25 with B-ALL,in which 19 cases of their TdT（＋） levels being 76%, 16 cases of their CD20 （＋） being 64%,24 cases of their CD79a（＋） being 96%. Both of the 2 groups are in high levels of expression of their MPO and their CD79a. Conclusion The sensitivity of the positive expression by the above immunohistochemistry means is of somewhat high liability keeping a very good concordance with the means of myelocyte smear,thus it has its applied value, therefore, can be treated as a significant reference marker in order to diagnose the acute leukemia.