156例儿童急性白血病免疫分型研究

Analysis of immunophenotyping for 156 successive cases of children with acute leukemia by flow cytometry

目的研究儿童急性白血病免疫分型特点,了解儿童急性白血病抗原表达规律和免疫亚型分布情况。方法采用CD45/SSC双参数设门方法的三色流式细胞术检测白血病细胞膜表面及胞浆内分化抗原。结果 156例儿童急性白血病免疫可分为4类:未分化型占0.7%,急性淋巴细胞白血病69.2%,急性髓细胞白血病25%,急性混合型白血病5.1%。108例儿童ALL中,B淋巴细胞白血病(B-ALL)占90.7%,T淋巴细胞白血病占9.3%,CD10、CD19、CD20在B-ALL中表达较高,阳性率分别为83.5%、98.9%、21.6%。CD13、CD33、CD117、胞浆内MPO在AML各亚型中有较高的表达率,阳性率分别为94.8%、94.8%、67.6%、86.5%,AML-M3患者CD34及HLADR呈低表达,均明显低于其他髓系白血病,差别有统计学意义(P<0.05)。结论免疫分型技术在儿童急性白血病患者诊断中具有重要意义,是骨髓形态学诊断的有力补充。

Objective To investigate the immunophenotyping characteristics of children with acute leukemia, and to comprehend the regular patterns of CD antigens in children with acute leukemia. Methods The 3-color flow cytometry and CD45/Side Scatter （SSC） gating were used to analyze the surface and cytoplasmic （Cy） antigens expressed in 156 successive cases of children with acute leukemia. Results Based on the diagnostic criterions proposed by European Group for the Immunological Characterization fo Leukemia （EGIL）, 4 categories were divided into： the undifferentiated type accounted for 0.7%, acute lymphocytic leukemia （ALL） 69.2%, acute myeloid leukemia （AML） 25%, and mixed lineage AL 5.1%. Of 108 pa- tients with ALL, 90.7% were classified as B lineage ALL and 9.3% as T lineage ALL. CD10, CD19 and CD20 antigens were highiy expressed in B-ALL, with positive percentage of 83.5%, 98.9%, 21.6%. And CD13, CD33, CDll7 antigens were highly expressed in AML, With positive percentage of 94.8%, 94.8%, 67.6%, 86.5%. CD34 and HLADR were lower in patients with AML-M3 than other types of AML, the differences were significant （P 〈 0.05）. Conclusion Immunophenotyping with flow cytometry is of great significance in children with acute leukemia, and is a useful assistant tool to morphology.