急性淋巴细胞白血病免疫表型的研究及其临床意义

Characteristics of immunophenotype in acute lymphoblastic leukemia and its clinical significance

目的研究急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)免疫表型的特点及其临床意义。方法应用流式细胞术(flow cytometry,FCM)检测33例初诊ALL患者的免疫表型。结果①33例ALL分为B-ALL(75.76%),T-ALL(12.12%)和T/B-ALL(12.12%)。②B-ALL中CD19表达率最高,占100%;T-ALL中CD7与cCD3表达率均为100%;CD20在成人及儿童组B-ALL表达率分别为23.53%、62.5%,两组比较差异有统计学意义(P<0.05);CD22在成人及儿童组B-ALL表达率分别为29.41%、62.5%,两组比较差异有统计学意义(P<0.05)。③33例ALL中髓系抗原表达阳性率为60.61%,髓系抗原阳性与阴性患者完全缓解率之间的比较无统计学差异(P>0.05)。④33例ALL中CD34阳性表达率为66.67%,CD34阳性与阴性患者CR率之间的差异无统计学意义(P>0.05)。结论CD19、cCD79a分别是B-ALL中高敏感性抗原和高特异性抗原,CD7、cCD3分别是T-ALL中高敏感性抗原和高特异性抗原;儿童组CD20和CD22表达率明显高于成人组;髓系抗原和CD34的表达与CR率无相关性。

Objective To study the feature of immunophenotype in acute lymphoblastic leukemia（ALL） and its clinical significance.Methods Immunophenotype was performed in 33 ALL patients by three-color flow cytometry.Results ① The 33 patients were identified into B-ALL（75.76%）,T-ALL（12.12%）,T/B mixed ALL（12.12%）.② In B-ALL patients,the CD19 had the highest expression rate（100%）;In T-ALL patients,the expression rate of antigen cCD3 or CD7 was 100%.The expression rate of CD20 in B-ALL among adults and children was 23.53%,62.5%,respectively there was a significant difference between the two groups（P0.05）,and the expression rate of CD22 in B-ALL among adults and children was 29.41%,62.5%,respectively there was a significant difference between the two groups（P0.05）.③ In 33 cases of ALL,the positive rate of myeloid antigen was 60.61%,there was no significant difference in complete remission between the patients expressed myeloid antigen positive and negative（P0.05）.④ In 33 cases of ALL,the positive rate of CD34 was 66.67%, There was no significant difference in complete remission between the patients expressed CD34 positive and negative（P0.05）.Conclusion In the patients with B-ALL CD19 has the top degree of sensitivity,the cCD79a has the top of specificity.In the patients with T-ALL CD7 has the highest sensitivity,cCD3 has the highest specificity;The expression rate of CD20 and CD22 in children is higher than adults;No significant association is found between the expression of myeloid antigen or CD34 and CR rate.