急性白血病的抗原表达及其临床意义

Immunophenotype of Acute Leukemia and Its Clinical Significance

目的 探讨成人急性白血病 (AL)的抗原表达及其临床意义。方法 采用直接免疫荧光法标记 ,流式细胞仪检测分析 6 9例 AL 的免疫表型。结果 12 9例成人急性淋巴细胞白血病 (AL L)髓系抗原阳性表达率为 30 % ,其中 CD1 3为 2 0 .7% ,CD33 为 10 .3% ,T- AL L 和 B- AL L 髓系抗原表达无显著性差异 (P=0 .36 7) ;CD34表达阳性的 AL L 髓系抗原表达率明显高于 CD34表达阴性的 AL L 髓系抗原表达率 (77.8% vs13.3% ,P=0 .0 36 ) ;AL L髓系抗原阳性表达的 CR率明显低于髓系抗原阴性表达的 CR率 (33.3% vs80 % ,P=0 .0 2 0 3)。 2 40例急性髓性白血病 (AML)淋系抗原表达率为 30 % ,其中 CD7为 15 % ,CD1 9为 12 .5 % ,CD2 为 2 .5 % ,CD7主要分布在 M1 、M2亚型中 ;CD34阳性 AML 的淋系抗原表达率明显高于 CD34阴性 AML 的淋系抗原表达率 (6 1.1% vs4.5 % ,P=0 .0 0 0 12 5 ) ;AML 淋系抗原阳性表达的 CR率低于淋系抗原阴性表达的 CR率 ,但差异无显著性 (5 0 % vs71.4% ,P=0 .12 6 )。结论 成人 AL 的抗原错译表达率约为 30 % ;CD34阳性 AL 的抗原错译表达率明显高于 CD34阴性 AL的抗原错译表达率 ;有抗原错译表达的 AL 的 CR率低于无抗原错译表达的 AL 的

Objective To examine the immunophenotype of adult acute leukemia and analyze its clinical significance. Methods Immunophenotypes were examined by direct immunofluorescence method and flowcytometry in 69 de novo AL. Results ① The incidence of myeloid antigen expression in 29 adult ALL was 30%. Among them, CD 13 was 10.3% and CD 33 was 20.7% , no difference was found in expression of myeloid antigens between B ALL and T ALL( P >0.05). Myeloid antigens were expressed much more higher in CD 34 positive ALL than in CD 34 negative ALL (77.8% vs 13.3%, P =0.036). CR rate in myeloid antigen positive ALL was lower than in myeloid antigen negative ALL (33.3% vs 80%, P =0.0203). ② The incidence of lymphoid antigen expression in 40 adult AML was 30%. Among them, CD 7 was 15%, CD 19 12.5% and CD 2 2.5%. CD 7 was mainly expressed in M 1 and M 2 subtypes. Lymphoid antigens were expressed higher in CD 34 positive AML than in CD 34 negative AML(61.1% vs 4.5%, P =0.000125). Though CR rate was lower in lymphoid antigen positive AML than in lymphoid antigen negative AML, no significant difference between them was noted (50% vs 71.4%, P =0.126). Conclusion Aberrant antigen expression in adult acute leukemia is about 30%. Antigen aberrant is much higher in CD 34 positive AL than in CD 34 negative AL. The CR rate of antigen aberrant AL is lower than that of usual AL.