成人急性B淋巴细胞白血病免疫表型分析

Analysis of immunophenotype of B lineage acute lymphoblastic leukemia in adult patients

目的研究成人急性B淋巴细胞白血病(B cell acute lymphoblastic leukemia,B-ALL)的免疫表型特点。方法采用四色流式细胞术CD45/SSC双参数散点图设门检测145例B-ALL患者免疫表型,并分析白血病相关免疫表型(leukemia associated immunophenotypes,LAIP)。结果所有检测病例中,表达率最高的淋系抗原为CD19、HLA-DR和CD79a,其次为CD34、CD10和CD20;髓系抗原CD13、CD33和CD15常伴随表达,CD117与T系抗原CD7和CD56很少表达。成人不同年龄组中Ⅱ型(CD10+/CD34+型)患者比例最高。B-ALL患者Ⅰ型和Ⅱ型的LAIP检出率较高,分别为100%、90.1%,Ⅲ型和Ⅳ型患者LAIP检出率明显低于Ⅰ型和Ⅱ型,分别为72.7%、63.6%。不同年龄组中,B-ALL各亚型之间及与总体之间检出率差异无统计学意义(P>0.05)。结论流式细胞术分析B-ALL免疫表型对白血病的正确诊断及其微小残留病(minimal residual disease,MRD)检测有重要意义。

Objective To investigate the immunophenotype of B cell acute lymphoblastic leukemia in adult patients. Methods Immunophenotyping was performed by flow cytometry in 145 adult patients with B cell acute lymphoblastic leukemia. Results The highest incidence of lymphoid associated antigens were CD19, HLA-DR and CD79a, followed by CD34, CD10 and CD20. B-ALL had a higher expression rate of myeloid antigens CD13, CD33 and CD15, CD117 and T antigens （CD7 and CD56） were rarely expressed. Subtype Ⅱ （ CD10^＋/CD34^＋ ） was predominant in three age groups of adults. The LAIP was observed in 100.0% and 90.1% patients of subtype Ⅰ and subtype Ⅱ, respectively, whereas only 72.7% and 63.6% in subtype Ⅲ and subtype Ⅳ. There was no significant difference in incidence of LAIP between three age groups （ P 〉 0.05 ）. Conclusion The immunophenotype by flow cytometry is of great value in correct diagnosis and minimal residual disease detection of B cell acute lymphoblastic leukemia.