表达融合基因的急性B淋巴细胞白血病患者形态学和免疫表型特点

Analysis of morphology and immunology of patients with B cell type acute lymphoblastic leukemia carrying fusion gene

目的:分析6种常见融合基因阳性的急性B淋巴细胞白血病患者骨髓形态学和免疫表型的特点。方法:对108例初诊的急性B淋巴细胞白血病患者,分别利用多重巢式RT-PCR技术和流式细胞术检测融合基因及其免疫表型,将BCR/ABL、TEL/AML1、E2A/PBX1、TLS/ERG、MLL/AF9、MLL/AF4 6种融合基因阳性者分成6组,分别与融合基因均为阴性者对比,比较形态学和免疫表型的差异。结果:108例急性B淋巴细胞白血病初诊患者中,共检出阳性43例(39.8%)。与阴性组相比,BCR/ABL阳性组患者CD10和CD34抗原的表达率升高;TEL/AML1阳性组和TLS/ERG阳性组患者以儿童为主,CD20抗原表达率降低;E2A/PBX1阳性组患者L1型所占比例较高,CD34抗原的表达率降低;MLL/AF9阳性组患者均高表达CD33抗原,MLL/AF4阳性患者缺乏CD13、CD33抗原的表达。结论:6种融合基因在患者年龄构成、形态学及免疫表型中具有一定的分布特点。可结合形态学和免疫表型,提高融合基因结果判读的准确率。

Objective：To analyse the characteristics of morphology and immunology of patients with B cell type acute lymphoblastic leukemia carrying six kinds of common fusion genes. Methods：Fusion genes examined by multiplex nested RT- PCR,immunology classification by flow cytometry,were applied to detect 108 patients with B cell type acute lymphoblastic leukemia. The patients carrying fusion gene were divided into 6 groups,respectively. They were BCR / ABL positive group,TEL / AML1 positive group,E2 A / PBX1 positive group,TLS / ERG positive group,MLL / AF9 positive group and MLL / AF4 positive group. The morphology and immunology of patients in six positive groups were compared respectively with negative group. Results：Six kinds of fusion genes were detected in 43 of 108cases（ 39. 8%）. Compared with negative group,the positive rate of CD10 and CD34 was higher in BCR / ABL positive group. The proportion of children was higher and the positive rate of CD20 was lower in TEL / AML1 positive group and TLS / ERG positive group. The proportion of FAB- L1 morphology was higher while the positive rate of CD34 was decreased in E2 A / PBX1 positive group. CD33 was highly expressed in all patients of MLL / AF9 positive group,CD13 and CD33 were found no express in MLL / AF4 positive group. Conclusion：There were certain distribution characteristics in age composition,morphology and immunology of patients with B cell type acute lymphoblastic leukemia carrying six kinds of common fusion genes. It can improve the accuracy of fusion genes by the supplementary role of morphology and immunology.