HLA-DR^(neg/low)急性单核细胞白血病的免疫学表型分析

Immunophenotype analysis of acute monocytic leukemia with HLA-DR^(neg/low)

目的探讨不表达或低比例表达HLA-DR(HLA-DR^(neg/low))急性单核细胞白血病(AML-M5)患者的免疫学表型特征。方法用多参数流式细胞术对111例急性单核细胞白血病(AML-M5)患者的骨髓细胞进行检测,分析其免疫表型。结果流式细胞术结果表明,HLA-DR抗原阴性表达者(HLA-DR^(neg))9例,低表达者(HLA-DR^(low))2例,且均表达CD13和CD33,不表达CD4,而CD34、CD38、CD117、CD15、CD64、CD14和CD56均呈异质性表达;与HLA-DR^(posi)阳性者相比,HLA-DR^(neg)/low者CD4的阳性率差异有统计学意义(P=0.015),其他抗原阳性率的差异均无统计学意义。结论 HLA-DR^(neg/low)的AML-M5患者CD抗原表达异常,多呈HLA-DR^(neg/low)/CD4^(neg)的表型特征,极易被误诊为其他类型的白血病。

Objective To investigate the immunophenotype characteristics of acute monocytic leukemia（ AML-M5） with HLA-DR^（neg/low）.Methods Bone marrow cells from 111 patients with AML-M5 were determined with multiparameter flow cytometry,and their immunophenotypes were analyzed. Results Among 111 patients with AML-M5,11 were identified to be HLA-DR^（neg/low）,including 9 negative and 2 low expression. All of 11 patients expressed CD13 and CD33,and didn＇ t express CD4. Other antigens,such as CD34,CD38,CD117,CD15,CD64,CD14 and CD56,were variously expressed. There was significant difference in the positive rate of CD4 between HLA-DRposi and HLA-DR^（neg/low）（ P =0. 015）,but not in the other antigens. Conclusion The AML-M5 patients with HLA-DR^（neg/low） have abnormal expressions of CD antigens,and don＇t express CD4,which are easy to be misdiagnosed as other types of leukemia.