成人急性淋巴细胞白血病细胞免疫表型与疗效的临床观察

Observation on the relationship between immunophenotyping of adult acute lymphoblastic leukemia cells clinical prognosis

探讨成人急性淋巴细胞白血病免疫表型与预后的关系。采用形态学、免疫学检测方法,对46例急性淋巴细胞白血病免疫表型进行回顾性分析总结。结果:①在T-ALL中,CD7、CD2表达率较高,B-ALL中CD19、CD10、CD20表达率较高,部分ALL中有髓系相关抗原CD33、CD13及祖/干细胞免疫表型CD34、HLA-DR表达,且其阳性表达率与ALL的预后相关;②46例ALL经诱导治疗后,38例CR,总CR率82.6%;CD13+ALL(51.8%)与CD13-ALL(66.7%)、CD34+ALL(51.1%)与CD34-ALL(61.4%)患者CR率相比无统计学意义(P>0.05),HLA-DR+ALL(48.6%)低于HLA-DR-ALL(75%),两者之间差别有统计学意义(P<0.05)。免疫分型为白血病的诊断、治疗及预后判断有重要的临床意义。

To investigate the relationship between immunophenotypes of adult acute lymphoblastic leukemia cells and clinical prognosis,morphological and immunological methods of detection were used to perform the prospective analysis on the immunophenotypes in 46 cases with adult lymphoblastic leukemia（ALL）.It was found that the expression rates of CD7 and CD2 were higher in cases with T-ALL and those of CD19,CD10 and CD20 higher in cases with B-ALL.In part of cases with ALL,expressions of myeloid associated antigen CD33,CD13 and the progenitor stem cell phenotype CD34 as well as HLA-DR were also demonstrated,and their positive rates were associated with the clinical prognosis of ALL patients.After induction therapy,CR was demonstrated in 38 cases from 46 cases with a total positive detection rate of 82.6%,while the positive detection rate for CD13＋ALL,CD13-ALL,CD34＋ALL and CD34-ALL were 51.8%,66.7%,51.1% and 61.4% respectively,no significant difference existed in the CR rate（P0.05）.The positive rates of HLA-DR＋ALL（48.6%） was lower than that of the HLA-DR-ALL with significant difference（P0.05）.From these observations,it is evident that immunophenotyping in cases of adult acute lymphoblastic leukemia shows diagnostic,therapeutic and prognostic significances.