急性早幼粒细胞白血病患者白血病细胞免疫表型分析

Acute promyelocytic leukemia cell leukemia phenotype analysis

目的探讨分析急性早幼粒细胞白血病白血病细胞的免疫表型以及其生物学意义。方法选取首次确诊为急性早幼粒细胞白血病患者71例,由经验丰富的医学检验人员按着检验结果对白血病细胞所引发的免疫表型进行划分,再分别将各个表型与急性白血病分型诊断标准(FAB)进行相关性分析。同时对当前未被重视的免疫表型CD64、CD117、CD9以及CD56采用小组讨论的方式进行分析。结果在急性早幼粒细胞白血病的白血病细胞中,髓过氧化物酶(MPO)、CD33以及CD13的阳性表达率最高,达100%,其次是CD123、CD9、CD45、CD117、CD19、CD64以及CD56。MPO、CD33和CD13在所有的APL患者中均有所表达,其表达强度分别为84.7%、92.4%和83.5%,强度较高,且MPO的阳性表达分布均匀,CD13分布较为密集。经过资料取证以及统计学分析可知,CD13、CD33、CD34、CD117、CD64以及CD56的阳性表达与FAB分型之间是相互独立的(P均>0.05)。CD9的阳性表达与FAB分型之间是相互关联的(P<0.05)。结论在所有的APL患者中MPO、CD13和CD33均有阳性表达,MPO在白血病细胞中阳性表达分布较为均匀,CD13在白血病细胞中的阳性表达分布较为集中。而大部分的免疫表型与FAB分型中的M3a和M3b之间无明显的线性关系。

Objective Our retrospective study was aimed to discuss the biological significance of the immune phenotype purified and sep-arated from patients with acute promyelocytic leukemia cells. Methods Clinical data of patients was retrospectively analyzed. 71 cases of acute promyelocytic leukemia patients first diagnosed were divided according to the test results on leukemia cells triggered immune phenotype by experi-enced medical examiner. Then the three established diagnostic criteria for classification of acute leukemia（ FAB）were analyzed. The value of phe-notype CD64,CD117,CD9 and CD56 was analyzed and discussed by group. Results A total of patients were retrospective analyzed. In acute promyelocytic leukemia cells in leukemia cells,myeloperoxidase（ myeloperoxidase,MPO）,CD33 and CD13 expression rate was the highest,reac-hing 100%,followed by CD123,CD9,CD45,CD117 ,CD19,CD64 and CD56. MPO,CD33 and CD13 were expressed in all patients in both APL,their expression level was respectively 84. 7%,92. 4% and 83. 5%,with higher strength. and the uniform expression of MPO was distribu-ted,the uniform expression of CD13,CD33,CD34,CD117,CD64 and CD56 and FAB classification was independent（ P 〉0. 05）;the expression of CD9 and FAB classification are interrelated（ P 〈0. 05）. Conclusion The expression of MPO is in all APL patients. The expression of CD13 and CD33,and MPO in leukemia cells is more evenly distributed. The distribution of CD13 expression in leukemia cells is more concentrated. There is no significant linear relationship between the majority of the immune phenotype and FAB classification of M3a and M3b.