急性髓系白血病微小残留病灶检测方法的建立及其应用

Establishment and Application of Detection Method for Minimal Residual Disease in Acute Myeloid Leukemia

目的依据白血病相关免疫表型的抗原表达规律,建立急性髓系白血病微小残留病灶检测方法.方法应用多参数流式细胞术对白血病细胞特征性抗原进行检测,所用荧光抗体涵盖了抗原跨系表达、抗原跨阶段表达,并注意抗原过度、过低或缺失表达以及光散射异常等情况,计算白血病细胞占全部检测细胞百分率,即MRD检测量.结果23例患者抗原不同步表达CD33\CD13\CD15\CD34\CD45的抗体组合应用最多,占56.52%(13/23);CD33\CD13\CD15\CD117\CD45的抗体组合占21.74%(5/23).抗原跨系表达的抗体中CD33\CD13\CD19\CD34\CD45和CD33\CD13\CD7\CD34\CD45比例相对较少,分别为17.39%(4/23)和4.35%(1/23).生存期大于2 a的患者MRD数值明显低于生存期小于2 a的患者,差异具有统计学意义(P<0.01).结论急性髓系白血病微小残留病灶检测是临床预后判断的重要参考指标.

Objective According to the antigen expression pattern of leukemic associated immunophenotype(LAIP),to establish a method for detecting minimal residual lesions in acute myeloid leukemia.MethodMulti-parameter flow cytometry was used to detect the characteristic antigen of leukemia cells.The fluorescent antibody should cover the cross lineage expression and cross phase expression of antigen.The excessive,low or missing expression of antigen and abnormal light scattering should be paid attention to.The percentage of leukemia cells in all detected cells was calculated,that is,the detection amount of MRD.ResultsIn 23 patients,the combination of antibodies expressing CD33,CD13,CD15,CD34 and CD45 asynchronously accounted for 56.52%(13/23);The antibody combination of CD33,CD13,CD15,CD117 and CD45 accounted for 21.74%(5/23).The proportion of CD33/CD13/CD19/CD34/CD45 and CD33/CD13/CD7/CD34/CD45 were relatively small,which were 17.39%(4/23)and 4.35%(1/23)respectively.The MRD value of patients with survival time more than 2 years was significantly lower than that of patients with survival time less than 2 years(P<0.01).ConclusionDetection of minimal residual disease in acute myeloid leukemia is an important reference index for clinical treatment and prognosis.