T系急性淋巴细胞白血病免疫表型、细胞遗传学及临床特征的研究

A correlation study of immunophenotypic,cytogenetic,and clinical features of T-ALL patients

目的:对初诊的46例急性T淋巴细胞白血病(T-ALL)患者进行免疫表型检测,并对其与临床生物学特征的关系进行探讨。方法:采用CD45/SSC参数设门多色流式细胞术检测46例成人及儿童T-ALL患者治疗前骨髓细胞的免疫表型,分析髓系抗原MyAg+与MyAg-的T-ALL患者临床生物学特征,染色体R显带技术对其中的30例进行核型分析。结果:46例T-ALL患者中,T系表面抗原表达依次为CD7、CD5、CD2、CD3、CD8和CD4。干、祖细胞标志CD3 8、CD3 4和HLA-DR阳性率分别为100.0%、28.3%和32.6%。41.3%T-ALL患者表达MyAg+,以CD13(21.7%)和CD117(22.5%)最常见。可供核型分析的30例患者中核型异常者17例(56.7%)。MyAg+T-ALL与MyAg-T-ALL患者临床和生物学特征分析表明MyAg+组白细胞中位值、血红蛋白水平均低于MyAg-组(P<0.05),MyAg+组CD34+患者比例(52.6%)高于MyAg-组(11.1%)(P<0.01),MyAg+组脾脏浸润患者比例(36.8%)低于MyAg-组(66.7%)(P<0.05)。结论:MyAg表达与外周血白细胞数、血红蛋白水平、脾脏浸润及CD34表达有关。

Objective ：To study the immunophenotype of 46 patients with T -lineage acute lymphoblastic leukemia （ T - ALL） and its association to biological and clinical features. Methods： Immunophenotyping of 46 adult and chil- dren cases of T - ALL were examined by CD45/SSC double parameters and multi - color flow cytometry, and the clini- cal and biological characteristics of T - ALL patients between MyAg ＋ and MyAg- groups were analyzed. 30 cases were also subjected to karyotype analysis by R - banding technology. Results： Of 46 ALL patients, CD7 was found to be expressed most commonly in T - ALL, followed by CD5, CD2, CD3, CD8 and CD4. The positive rates of stem/pro- genitor cell markers CD38, CD34 and HLA - DR in T - ALL were 100.0% ,28.3% and 32.6% , respectively. MyAg expression was documented in 41.3% of the 46 T - ALL cases analyzed. CD13（21.7 % ） and CDl17（22.5% ） were the most commonly expressed myeloid antigen in T - ALL patients. Abnormal karyotypes were detected in 17 out of 30 （56.7%） cases. The clinical and biological characteristics of T- ALL patients between MyAg＋ and MyAg- groups showed that decreased median WBC count and hemoglobin level, higher CD34 positivity, lower proportion of patients with splenomegaly were found to be correlated with MyAg ＋ ALL. Conclusion： MyAg expression was signifi- cantly associated with median WBC count and hemoglobin level, splenomegaly and CD34 expression.