急性非淋巴细胞白血病MIC分型及其与预后的关系

Study on MIC classification and its relationship with prognosis of patients with acute non-lymphocytic leukemia

目的:探讨急性非淋巴细胞白血病(ANNL)MIC分型及其与预后关系。方法:43例ANLL患者进行形态学分型,采用流式细胞术检测白血病细胞免疫类型,骨髓短期培养,G显带技术分析染色体核型,分析比较MIC结果及其与预后的关系。结果:ANLL患者髓系系列CD13、CD33和MPO的表达最为常见,阳性率分别为100.00%、95.38%和53.49%;干/祖细胞CD38、HLA-DR和CD34的阳性率分别为83.72%、74.42%、74.42%,各系列单抗在FAB各亚型原始细胞的表达水平不同,其中CD34和CD7分别在急性混合细胞白血病(HAL)和M5高表达;细胞遗传学检查染色体异常率为53.49%,其中复杂异常的患者CR率明显低于其他组。2例FAB分型为M0的患者免疫分型为HAI,3例M5和2例M4为伴淋巴系抗原表达的ANLL。结论:形态学结合免疫分型和细胞遗传学检查可以准确地了解白血病细胞的生物学性质,指导临床治疗和判断预后,尤其对于形态学特征不明显的HAL等患者更有价值。

Objective：To explore MIC classification and its relationship with prognosis of the patients with acute non-lymphocytic leukemia. Methods： 43 patients with acute non-lymphocytic leukemia were diagnosed by morphological classification, and leukemic ceil immunological classification was examined by flow cytometry（FCM）, the chromosome karyotype was analyzed by G-banding technique after short time bone marrow culture, then the relationship between MIC classification and prognosis was analyzed. Result： Myeloid antigens of CD13, CD33 and MPO were the most common expression antigens, with the positive rates of 100.00%, 95.38% and 53.49%, respectively. The positive rates of CD38, HLA-DR and CD34 were 83.72%,74.42% and 74. 42%, respectively. The expressive levels of monoclonal antibodies in FAB subgroup were different and the expression of CD34 and CD7 were higher in HAL and M5, respectively. The chromosomal abnormality rate detected by cytogenetics was 53.49%, and the complete remission （CR） rate in the patients with complex chromosomal abnormalities was lower than that of other groups. 2 patients with MO were acute mixed cell leukemia, 3 patients of M5 and 2 patients of M4 were ANLL expressed lymphotic lineage-associated antigens. Conclusion： MIC classification can correctly investigate the biologic features of leukemic cells, and guide clinical treatment and estimate prognosis, especially for patients with no obvious morphologie features.