慢性B淋巴细胞白血病的免疫表型及预后的临床研究

RESEARCH ON IMMUNOPHENOTYPE AND ITS PROGNOSIS OF 37 PATIENTS WITH B CHRONIC LYMPHOCYTIC LEUKEMIA

目的探讨慢性B淋巴细胞白血病(B-CLL)的免疫表型特征及预后。方法采用CD45/SSC双参数散点图设门,应用流式细胞术对37例初诊CLL患者骨髓标本进行免疫分型,另外选择同期32例急性淋巴细胞白血病(ALL)患者作为对照。结果①37例患者中HLA-DR、CD19、CD20及CD5表达最常见,阳性率依次为100.0%、100.0%、95.0%及86.4%,CLL患者无一例表达CD34;②与ALL mature-B相比,CLL高表达CD5(P<0.05),而CD10和CD34的表达率则偏低(P<0.05),HLA-DR、CD19及CD20的表达差异无统计学意义(P>0.05)。结论 CLL的免疫表型特征为CD5、CD19及CD23的共表达;CD19和CD20诊断CLL的灵敏度高,但特异性不高;CD5,CD10可作为B-CLL与Mature-B-ALL鉴别诊断的特异性指标。

Objective To explore the characteristics of immunophenotype and prognosis of chronic lympho- cytic leukemia（CLL）. Methods Immunophenotyping was performed in 37 CLL patients by flow cytometry analysis using CD45/SSC gating. At the same time, 32 newly diagnosed acute lymphocytic leukemia（ALL） were selected at random as control. Results In the 37 CLL cases, almost all of them expressed CD19, CD20, and CD5 with the positive rate 100.0%, 95.0% and 86.0% respectively. All of the 37 patients ex- pressed HLA- DR and none of them expressed CD34, Compared with ALL - Mature - B, B - CLL had higher expression of CD5 （P^0.05）, but lower expression of CD10 and CD34 （P%0. 05）. There were no significant differences in the expression of HLA- DR, CD19 and CD20 among them. Conclusions The co - expressing of CD5/CD19/CD23 is the typical immunophenoty of CLL. The sensitivity of CD19 and CD20 in diagnosis CLL is high,but low in specificity. CD5, CD10 can be used as the specific markers to distin- guish B- CLL and Mature - B- ALL.