急性髓细胞白血病免疫分型特点及临床意义

杨艳丽; 耿英华; 李佳佳; 李骏; 张凤

急性髓细胞白血病免疫分型特点及临床意义

Features of immunophenotype of acute myeloid leukemia and its clinical significance

摘要

摘要: 目的: 探讨急性髓细胞白血病(AML)免疫分型特点及其临床意义。方法: 采用流式细胞术(FCM)对145例AML患者进行白血病免疫分型检测。结果: 145例AML患者中MPO、CD13、HLA-DR、CD33、CD34表达率分别为93.1%、90.3%、77.2%、71.7%、70.3%。CD14仅表达于急性粒单细胞白血病(M4)和急性单核细胞白血病(M5)。AML伴淋系抗原表达者以CD7(34.5%)最为多见,其中以预后较差的M5型表达率为最高,其次为CD19(10.3%),且在急性粒细胞白血病部分分化型(M₂)中表达率最高。CD2仅表达于部分急性早幼粒细胞白血病(M3),共发现2例急性混合细胞白血病,同时有淋系和髓系抗原表达。结论: MPO、CD13、CD33为髓系最敏感的抗原,CD7、CD19、CD2淋系抗原在AML诊断及预后判断上有重要指导意义,FCM免疫分型对白血病的准确分型诊断,预后判断有重要的指导意义。

Abstract: Objective: To investigate the characteristics and clinical significance of immunophenotype in acute myeloid leukemia (AML). Methods: Immunophenotype was carried out in 145 patients with AML using flow cytometry. Results: The expression of MPO, CD13,HLA-DR,CD33 and CD34 was 93.1%,90.3%,77.2%,71.7% and 70.3%,respectively. CD14 was expressed only in the M4 and M5 subtype. The lymphoid antigen expression was most commonly observed in CD7 (34.5%),especially in M5 subtype and CD19 (10.3%); CD2 was expressed only in part of M3 subtype. Two cases of acute hybrid leukemia were detected,expressing both myeloid and lymphoid associated antigen. Conclusions: MPO, CD13 and CD33 are sensitive myeloid associated antigens. The expression of CD7,CD19 and CD2,as well as the immunophenotype by flow cytometry,is of great value in diagnosis and prognosis of AML.

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