急性早幼粒细胞白血病的细胞表面免疫分子的检测和分析

Detection and analysis of immune molecules in leukemia cell surfaces of acute promyelocytic leukemia

目的研究急性早幼粒细胞白血病(APL)表型特征及临床意义。方法采用流式细胞术四色方案对APL进行免疫分型,以CD45/SSC-lin图定位白血病细胞,依据抗原表达强度将抗原表达划分为五级分析。结果典型APL细胞抗原表达强度及所占比例依次为:CD33(100%)、髓过氧化物酶(MPO)100%、CD38(82.35%)、CD13(64.71%)、CD64(50%)、CD123(47.06)、CD117(44.12%),HLA-DR和CD34基本不表达;伴淋系表达APL患者化疗后缓解率明显低于阴性APL患者。结论 APL免疫分型典型表型特征为高侧向角散射(high SSC)、CD33^+(Ⅰ级)、CD38^+(Ⅰ级)、MPO^+(Ⅰ级)、CD13^+(Ⅲ级)、CD64^+(Ⅰ级/Ⅲ级)、CD117^+(Ⅱ级/Ⅲ级/Ⅳ级)、CD123^+(Ⅲ级/Ⅳ级)、CD11b^-、HLA-DR^-、CD34^-。掌握APL免疫表型特征有助于APL快速诊断,且对MRD检测有指导意义。

Objective To investigate the immunophenotypic characteristics of acute promyelocytic leukemia（APL） and its clinical significance.Methods Immunophenotyping was performed by four-color flow cytometry with CD45/SSC-lin gating for neoplastic cells and was divided into five levels according to the intensity of antigen expression.Results The expression intensity and percentage of typical APL phenotypes were：myeloperoxidase（MPO） and CD33 were consistently expressed（100%）;CD38（82.35%）,CD13（64.71%）,CD64（50%）,CD123（47.06%） and CD117（44.12%） were partial y expressed.HLA-DR（97.06%） and CD34（99.02%） were negative.Post-chemotherapy remission rate in the Lym ＋ APL patients was significantly lower than that in the Lym-APL patients.Conclusion The typical phenotypic characteristics in APL immunophenotyping were high SSC,CD33^＋（grade Ⅰ）,CD38^＋（grade Ⅰ）,MPO＋（grade Ⅰ）,CD13^＋（grade Ⅲ）,CD64^＋（grade Ⅰ/Ⅲ）,CD117^＋（grade Ⅱ/Ⅲ/Ⅳ）,CD123^＋（grade Ⅲ/Ⅳ）,CD11b^-,HLA-DR-,CD34^-.Understanding of the immunophenotypic features of APL contributes to rapid diagnosis of APL and the guidance of minimal residual disease（MRD） detection.