24例大颗粒淋巴细胞白血病患者免疫表型和临床特征分析

Immunophenotypes and Clinical Features of 24 Cases With Large Granular Lymphocyte Leukemia

目的:探讨大颗粒淋巴细胞白血病(LGLL)患者免疫表型与临床特征的关系。方法:收集24例LGLL患者流式细胞术免疫分型和临床资料,比较T/NK不同亚型间的差异。结果:在CD45/SSC点图上分析,24例LGLL患者骨髓/外周血均可见大颗粒淋巴细胞群。T-LGLL表达特异性T系抗原及大多数泛T抗原,均为CD8+CD4-亚型,侵袭性T-LGLL可见泛T抗原丢失,并伴T系抗原表达强度改变。NK-LGLL主要表达泛T标志CD2、CD7及CD56和CD11c,不表达T系特异性标志CD3、CD5,但在惰性和侵袭性病程中免疫表型无显著差异。T-LGLL惰性与侵袭性患者组间比较,平均年龄、WBC计数、淋巴细胞比例、血红蛋白含量和B症状差异有显著意义(P<0.05);NK-LGLL惰性和侵袭性患者组间比较在年龄、血红蛋白含量、肝脾淋巴结肿大和B症状间有显著差异(P<0.05)。结论:骨髓细胞或血细胞免疫表型分析可有助于诊断LGLL及T/NK亚型,而结合临床特征则有助于判断其侵袭性或惰性。

Objective： To investigate the correlation between immunophenotype and clinical features in patients with large granular lymphocyte leukemia （LGLL）. Methods： Immunophenotypic profile and clinical data of 24 patients with LGLL were collected, and differences between T / NK subtype were compared. Results： T-specific antigen and most pan-T antigen were expressed in T LGLL, but CD8 ＋ CD4 - was the subtype. Aggressive T-LGLL showed loss of one or more pan-T antigens and the change of immunofluorescence intensity in T antigen. Pan-T antigen CD2, CD7 and NK associated antigen CD56 and/or CD11c were often expressed in NK LGLL, but with no CD3 and CD5 expression, and the immunophenotypes presented no remarkable difference in NK LGLL indolent and aggressive subtype. There was significant difference in the average age, WBC count, lymphocyte proportion, hemoglobin and B symptoms between indolent and aggressive T-LGLL （P〈0. 05）, and there was significant difference in the average age, hemoglobin, hepatosplenomegaly, lymphadenopathy and B symptoms between indolent and aggres- sive NK-LGLL （P〈0. 05）. Conclusions： Analysis of immunophenotype combined with clinical characteristics is helpful for the diagnosis of LGLI. and T/NK subtype, and is helpful to determine its aggression or inertia.