免疫表型与急性白血病的分型诊断

FAB and Immunophenotyping in the Classifcation of Acute Leukemia

对426例急性白血病采用APAAP法23种单抗进行免疫分型研究.结果发现:(1)426例中,71.6%可确定为淋巴系或髓系或髓/淋混合型,28.4%不能确定细胞系列.FAB结果仅62.75%得到免疫表型证实,29.5%不能判断细胞起源,7.75%两者分型结果不一致;(2)ANLL140例中,44.29%免疫表型证实为髓细胞型,17.14%仅表达淋巴系标志,38.57%不能判断细胞起源,各髓系标志无明显FAB亚型特异性;(3)ALL260例中,72.67%进一步证实为淋巴细胞型,2. 69%单纯表达髓系标志或混合表达髓系和淋巴系抗原,另外24.62%不能确定细胞起源;(4)FAB不能分型26例中,23例可确定为ALL或ANLL,另外3例仍不能诊断.研究认为,免疫分型是FAB分型的必要补充.

426 patients with acute leukemia (FAB: ANLL 140 ALL 260 Undetermine type 26) were classified by immunophenotyping. 23 McAbs were used in APAAP technique in this study. The results showed: 1. In all 426 cases, 71. 6% could be classified as ALL ANLL or Mixed type, and 28.4% could not be classified. In comparison with FAB results, rate of identity was 62.75%; discordant rate was 7.75%. 2. In 140 cases of ANLL, only 44.29% were verified as ANLL; 17.14% were classified as ALL; 38.57% could not be classified, and no marker was subtype-specific. 3. In 260 cases of ALL, 72. 67% were confirmed as ALL and they were easily to be subtyped, and 2. 69% were classified as ANLL; 24. 62% could not be immunophenotyped. 4. In 26 cases of FAB undetermine type, 23 cases were diagnosed as ALL or ANLL, the other 3 cases could not be classified yet. These results suggest that immunophenotyping is an essential complement to FAB classification.