急性早期前体T淋巴细胞白血病免疫表型分析

Immunophenotypic analysis of early T-cell precursor lymphoblastic leukemia

目的:分析CD1a^-/CD8^-、My/S^+及CD5^(weak)对早期前体T淋巴母细胞白血病(ETP-ALL)诊断的意义及与临床特点的关系,以提高对ETP-ALL免疫表型及临床特点的认识。方法:回顾性分析55例初诊急性T淋巴细胞性白血病患者的流式免疫分型结果,分析CD1a^-/CD8^-、My/S^+、CD5^(weak)及ETP与各抗原表达阳性率的关系,以及CD1a^-/CD8^-、My/S^+和CD5^(weak)两两联合对ETP诊断特异性的影响,并比较ETP(CD1a^-/CD8^-、My/S^+、CD5^(weak)),near ETP(CD1a^-/CD8^-、My/S^+、CD5^(+++))及其他(others)组的临床基本特点。结果:多数抗原表达阳性率在CD1a^-/CD8^-和not CD1a^-/CD8^-组间、My/S^+和My/S^-组间及ETP和non ETP组间均差异有统计学意义。但在CD5^(weak)和CD5^(+++)组间,各抗原表达阳性率均差异无统计学意义。CD1a^-/CD8^-联合My/S^+对ETP的诊断特异度为75.8%,CD5^(weak)联合CD1a^-/CD8^-或My/S^+对ETP的诊断特异度均为90.9%。ETP,near ETP及others组年龄、白细胞计数及血小板计数均差异有统计学意义。结论:CD1a^-/CD8^-、My/S^+对ETP-ALL的识别与诊断具有重要意义,CD5^(weak)在ETP-ALL的鉴别诊断中具有重要价值,需要注意将符合CD1a^-/CD8^-、My/S^+,但CD5高表达的near ETP患者区分出来。ETP及near ETP均具有较独特的临床特点。

Objective:To analyze the significance of CD1a-/CD8-,My/S+and CD5weakin the diagnosis of early T-cell precursor acute lymphoblastic leukemia(ETP-ALL)and their relationship with clinical characteristics,so as to improve the understanding of the immunophenotype and clinical characteristics of ETP-ALL.Method:The results of immunophenotype in 55patients with newly diagnosed acute T-lymphoblastic leukemia were retrospectively was analyzed.The relationship between CD1a-/CD8-,My/S+,CD5weak,ETP and the positive ratio of different antigens was analyzed.The effects of CD1a-/CD8-,My/S+,and CD5weak on the specificity of ETP diagnosis were compared.Furthermore,basic clinical characteristics of ETP(CD1a-/CD8-,My/S+,CD5weak),near ETP(CD1a-/CD8-,My/S+,CD5+++)and other groups were compared.Result:The positive rates of most antigens were significantly different between CD1a-/CD8-vs not CD1a-/CD8-group;My/S+vs My/S-group and ETP vs non-ETP group.However,there was no significant difference of the positive rate of each antigen between CD5weak and CD5+++group.The diagnostic specificity of CD1a-/CD8-combined with My/S+for ETP was75.8%,and that of CD5weak combined with CD1a-/CD8-or My/S+for ETP was 90.9%.There were significant differences in age,leukocyte count and platelet count among ETP,near ETP and other group.Conclusion:CD1a-/CD8-and My/S+have great significance in the identification and diagnosis of ETP-ALL.CD5weak has great value in the differential diagnosis of ETP-ALL.It is necessary to distinguish near ETP patients with CD1a-/CD8-,My/S+and elevated CD5.Both ETP and near ETP have unique clinical characteristics.