慢淋、慢淋伴幼淋细胞增多及毛细胞白血病的临床、形态学和免疫学表型分析

The clinical,morphology and immunophenotype of chronic lymphocytic leukemia (CLL),chronic lymphocytic leukemia with prolymphocytosis (CLL/PL)and hairy cell leukemia (HCL)

目的:探讨慢性淋巴细胞白血病 ( CL L )、慢淋伴幼淋细胞增多症 ( CL L / PL )及毛细胞白血病 ( HCL )免疫表型特点。方法:应用单克隆抗体 ( Mc Ab)对 4 5例淋巴细胞白血病进行免疫表型检测 ,并观察其形态学特点。结果 :4 5例患者中 ,B- CL L4 2例 (包括 5例 B- CL L/ PL) ,T- CL L 2例 ,B细胞型毛细胞白血病 ( B- HCL) 1例。男性患者与女性患者之比为 2 .3∶ 1,B- CL L 与 T- CL L 之比为 2 0∶ 1。B- CL L 患者显示有 T-淋系抗原 CD5+,T- CL L 可分别表达 CD4 +CD8-及 CD8+CD4 - ,1例 B- HCL 显示典型的 B-淋系抗原阳性 ,同时免疫电镜淋巴细胞为毛状突起。 结论 :B- CL L CD5、CD1 9、CD2 0 、HL A- DR较特异 ;B- CL L/ PL CD2 0 、CD2 2 、Sm Ig有一定参考价值 ;B- HCL 除 B淋系抗原可表达阳性外 ,CD2 5+、CD5- 最有诊断鉴别意义 ;T- CL L可呈现多样性 T-淋系免疫标记。免疫表型分析有助于区别 T、B- CL L、幼淋及 HCL。

Objective: To study the immunophenotype of CLL, CLL/PL and HCL. Methods: The immunophenotypes were detected by monoclonal antibody and morphology were observed in 45 lymphocytic leukemia. Results: There were 42 cases of B CLL(including 5 cases of chronic lymphocytic leukemia with prolymphocytosis B CLL/PL), 2 cases of T CLL and one case of B HCL in 45 patients.The proportion of male to female was 2.3∶1 and B CLL to T CLL was 21∶1. 81% of B CLL expressed T linkage antigen CD\-5\++. T CLL expressed CD\-4\++, CD\-8\+- and CD\-4\+-, CD\-8\++. The B HCL case expressed typical B linkage antigen and the immunoelectron microscopic view of the lymphocytes giving the hairy or microvilli appearance. Conclusion: CD\-5, CD 19 , CD 20 , HLA DR have significant value in B CLL; CD 20 , CD 22 , SmIg have referential value in B CLL/PL; B HCL expressed B linkage antigen, among them CD 25 \++, CD\-5\+- have the most important diagnostic value; T CLL have diversity of expressing T linkage markers. Immunophenotyping helps to differentiate the T CLL、B CLL、PL and HCL.