CD64在急性白血病免疫分型中的意义

Significance of CD64 in immunophenotyping of acute leukemia

目的探讨CD64在急性白血病免疫分型中的意义。方法应用直接荧光标记法,经流式细胞术对116例急性髓系白血病(AML)和70例急性淋巴细胞白血病(ALL)进行免疫表型的检测。结果 AML组CD64的表达阳性率明显高于ALL组(41.4%vs 2.9%,P<0.01)。CD64在M5和M4的表达阳性率最高,分别为77.1%和55.6%。CD64的阳性表达率在M0(0)、M1(0)、M2(7.9%)明显低于M3(47.1%)、M4与M5(P<0.01)。各亚型CD64阳性病例中,M4、M5的CD64阳性细胞表达率分别为(62.5±24.7)%、(68.7±25.9)%,均明显高于M2(28.3%±5.7%)、M3(34.3%±6.3%)(P<0.01)。CD64对诊断AML的灵敏度优于CD14,其特异度优于CD117、CD33及CD13。虽然CD64诊断M4\M5的特异度较CD14稍差(82.5%vs 100%),但是灵敏度高于CD14(69.8%vs 41.5%)。结论 CD64可作为辅助诊断AML的髓系标志抗原,有助于提高M4/M5的检出率及其与其他AML亚型的鉴别诊断。

This study is assigned to explore the significance of CD64 in immunophenotype of acute leukemia（AL）.We used flow cytometry with direct immunofluorescence staining to analyze the immunophenotype of 116 patients with acute myeloid leukemia（AML） and 70 patients with acute lymphoblastic leukemia（ALL）.We found that the CD64 positive rate in AML was significantly higher than that in ALL（41.4% vs 2.9%,P0.01）,and demonstrated the highest level in M5（77.1%） and M4（55.6%）;the positive rates in M0（0）,M1（0）,M2（7.9%） were significantly lower than those in M3（47.1%）,M4 and M5（P0.01）.In CD64 positive cases,the CD64 expression rates in M4（62.5%±24.7%） and M5（68.7%±25.9%） were significantly higher than those in M2（28.3%±5.7%） and M3（34.3%±6.3%）（P0.01）.The sensitivity of CD64 in the diagnosis of AML was superior to CD14,and the specificity was superior to CD117,CD33,and CD13.Although the specificity of CD64 in the diagnosis of M4/M5 was lower than that of CD14（82.5% vs 100%）,but its sensitivity was higher than that of CD14（69.8% vs 41.5%）.In conclusion,our study demonstrates that CD64 can be used as myeloid marker for the diagnosis of AML,which will be helpful to improve the detection rate of M4/M5 and the differential diagnosis for M4/M5 from other AML subtypes.