急性白血病免疫分型及交叉表达的临床意义

CLINICAL SIGNIFICANCE OF IMMUNOPHENOTYPE AND CROSS-LINEAGE EXPRESSION OF ACUTE LEUKEMIA

目的 :研究急性白血病 (AL)免疫分型及其特殊表型——交叉表达的特征及临床意义。方法 :选用 1 6种单克隆抗体 ,应用直接及间接免疫荧光标记方法 ,对 1 2 8例急性白血病患者进行免疫分型。结果 :按免疫表型的特征可将其分为 3类 :系列专一性表达 ;交叉表达 ;“裸细胞”型。以系列专一性比例最高 ,在 ANL L 和 AL L 中分别占 73.3%和 78.9% ;“裸细胞”型最低 ,在 ANL L 和 AL L 中分别占 6 .7%和 5 .3% ;交叉表达在 ANL L 和 AL L 中分别占 2 0 .0 %和 1 5 .8%。且交叉表达的病例中 ,CD+ 7ANL L 以及伴有 B系抗原表达的 ANL L 患者 CR率均低于系列专一性表达者 ,p1 70表达率较高。结论 :急性白血病免疫分型可出现系列专一性表达、交叉表达、“裸细胞”型 3种类型 ;交叉表达的患者可伴有 p1 70高表达 。

Objective:To study the clinical significance and characteristic of acute leukemia (AL) immunophenotype and cross lineage expression. Methods:128 patients with AL were investigated by immunophenotyping with 16 monoclonal antibodies. Results:According to the antigen expression ,they could be classified into three subgroups: (1) lineage specific expression; (2) cross lineage expression; (3) “null cell”type. The incidence of lineage specific expression in ANLL and ALL was 73.3 % and 78.9 % respectively , which was the highest . “null cell”type was the lowest , which was 6.7 % and 5.3 % , the incidence of cross lineage expression in ANLL and ALL was 20.0 % and 15.8 %.In ANLL with CD + 7 or B lymphocytic lineage antigen expression,the CR rate was lower,while the incidence of p170 expression was higher than that with the lineage specific expression.Conclusion:(1) AL immunophenotype might be classified into three subgroups:lineage specific expression;cross lineage expression and “null cell”type.(2) Higher p170 expression and lower CR rate was seen in the patients with cross lineage expression than that with lineage specific expression.