急性早幼粒白血病的细胞形态学与免疫表型研究

Study of cell morphology and immunophenotype of acute promyelocytic leukemia

目的研究急性早幼粒白血病细胞(Acute promyelocytic leukemia,APL)形态学和免疫表型的相关性,为进一步提高APL患者诊断率和优化分型提供依据。方法选取2015年8月至2016年8月某医院收治的首次确诊为APL的80例患者为研究对象。采用骨髓细胞涂片镜检进行FAB分型,以及流式细胞术(Flow cytometery,FCM)对患者骨髓细胞进行免疫表型分析。结果 80例APL患者经FAB分型,确诊为M3a型47例,M3b型33例。两种亚型患者的Hb、RBC均值均低于正常;M3a型患者的Hb、RBC、BPC、WBC均显著低于M3b型,早幼粒细胞占比显著高于M3b型,差异均有统计学意义(P值均<0.05)。CD13、CD33、CD117、CD9、CD34抗原在APL患者中表型均为阳性高表达,M3a型患者中CD9阳性率(68.08%)明显低于M3b型患者(90.09%),差异有统计学意义(P<0.05)。结论 APL患者骨髓细胞免疫表型有一定的特征性,值得进一步深入研究。其中CD9与APL患者FAB分型相关。

Objective To study the correlation between morphology and immunophenotype of acute promyelocytic leukemia （APL） ; to provide basis to further improve the diagnosis rate and optimize the classification of APL patients. Methods A total of 80 patients first diagnosed as APL admitted 1o a certain hospital from Aug 2015 to Aug 2016 were selected as subjects. Bone marrow cell smears were used for FAB classification, flow cytometry （FCM） was used to analyze immunephenotype of patients＇ myeloid cells. Results Among 80 APL patients, 47 were confirmed as M3a subtype and 33 were confirmed as M3b subtype by FAB classification. The mean values of Hb and RBC of both subtypes were lower than normal people; the Hb, RBC, BPC and WBC of M3a subtype patients were significantly lower than those of M3b patients,while promyeloeytie ratio of M3a subtype patients was significantly higher than that of M3b subtype patients, with statistical difference（all P〈0. 05）. CD13, CD33, CD117, CD9 and CD34 antigens expression level were highly positive in APL patients. The positive rate of CD9 in M3a subtype patients （68.08%） was significantly lower than that of M3b subtype patients （90.09%）, with statistical difference（P〈0.05）. Conclusion The bone marrow cell immunophenotype of APL patients have certain characteristics;fur- ther study should be conducted. CD9 was associated with FAB classification among APL patients.