免疫双标记细胞的检测在中枢神经系统白血病诊断中的意义

Double color immunofluorescent cells detecting in cerebrospinal fluid in central nervous system Leukemia

目的 :观察末端脱氧核苷酸转移酶 (TdT)及淋巴细胞系列相关抗原双标记细胞在脑脊液中的检出对中枢神经系统白血病 (CNS L)的临床意义。方法 :采用免疫荧光标记技术配合流式细胞术 ,检测初治或完全缓解期急性淋巴细胞白血病脑脊液中TdT及淋巴系列相关抗原双标记细胞及其治疗后的变化。结果 :6 4例中 8例脑脊液检出上述免疫双标记细胞 ,均为急性淋巴细胞白血病 ,其中 1例无CNS L临床迹象 ,免疫双标记细胞占3.38% ,经治疗后免疫双标记细胞在脑脊液均明显减少或消失。结论 :脑脊液中免疫双标记细胞的检出对CNS L的诊断及治疗指导具有重要的临床意义 。

Objective:To observe the implications of the cells coexpressing terminal deoxynucleotydyl tranferase (TdT) and lymphocytic lineage-associated antigensn cerebrospinal fluid in acute leukemia. Method:The double color immunofluorescence assay with flow cytometry was used to detect the cells described above in cerebrospinal fluid of acute luekemia. Result:In 64 patients with acute lukemia, the duoble color immunofluorescent cells were detected in 8 cases who were all acute lymphoblastic leukemia. The clinical sign of CNS-L presented in 7 cases and the remained one cases showed cinically no CNS-L. The duoble color immunofluorescent cells in cerebrospinal fluid accouted for 38%. The cells above reduced or disapeared after the effective intrathecal methotrexate treatment.Conclusion:The detection of the double color immunofluorescent cells in cerebrospinal fluid in CNS-L is more important than routine cell morphology.