69例慢性淋巴细胞白血病的免疫表型及骨髓象分析

Immunophenotype and bone marrow of chronic lymphocytic leukemia

目的研究慢性淋巴白血病的免疫表型与骨髓象的特点,以期为临床诊治提供一定的参考。方法选取2013年1月至2015年1月间入院诊治的慢性淋巴细胞白血病患者69例,应用单参数和多参数流式细胞术分析患者的免疫表型,对患者进行骨髓象及血象检查,对患者的骨髓增生度进行分析。结果 69例CLL患者中,LL/SL-MC 33例(47.83%)、CLL/PLL-MC 16例(23.19%)、TSL 9例(13.04%)、ATLL 4例(5.80%)、PLL 4例(5.80%)、HCL 3例(4.34%)。CLL患者以年龄50岁以上者居多。骨髓增生度极度活跃12例(17.39%)、明显活跃10例(14.49%)、活跃47例(68.12%),粒红比增高17例(24.64%)、正常29例(42.03%)、降低23例(33.33%),巨核细胞计数增高3例(4.35%)、正常30例(43.48%)、降低36例(52.17%)。69例患者全部表达CD19、CD20,阳性率为100%;其次表达CD22,阳性率为98.55%;CD23阳性率为97.10%,CD5阳性率为86.96%;所有患者均不表达CD10。结论 69例CLL患者免疫分型以混合型为多,骨髓增生度较高;免疫表型则以CD19、CD20全部表达,其次分别表达为CD22、CD23与CD5,不表达CD10。

Objective To study the characteristics of immunophenotype and bone marrow in chronic lymphocytic leukemia（CLL）in order to provide certain reference for its clinical diagnosis and treatment.Methods A total of 69 cases of CLL in our hospital from January 2013 to January 2015 were selected.The immune 69 cases was analyzed by using the single parameter and multiparameter flow cytometry.The bone marrow and blood examinations were performed and the myeloproliferative degree was analyzed.Results Among 69 cases of CLL,33cases（47.83%）were LL/SL-MC,16cases（23.19%）were CLL/PLL-MC,9cases（13.04%）were TSL,4cases（5.80%）were ATLL,4cases（5.80%）were PLL and 3cases（4.34%）were HCL.The majority of CLL cases were more than 50 years old.The myeloproliferative degree was hyperactive in 12cases（17.39%）,significantly active in10cases（14.49%）and active in 47cases（68.12%）;the myeloid-erythroid ratio was increased in 17cases（24.64%）,normal in29cases（42.03%）and reduced in 23cases（33.33%）;the megakaryocyte count was increased in 3cases（4.35%）,normal in 30cases（43.48%）and reduced in 36cases（52.17%）.All 69 cases expressed CD19 and CD20with the positive rate of 100%;secondly expressed CD22 with the positive rate of 98.55%;the CD23 positive rate was 97.10%,the CD5 positive rate was 86.96%;all cases did not express CD10.Conclusion The immunophenotype in 69 cases of CLL was mainly the mixed type with higher myeloproliferative degree;the immunophenotype expressed CD19 and CD20in all cases,secondly expressed CD22 and CD23,and did not express CD10.