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目的:探讨急性髓系白血病(AML)免疫表型特点及其与预后的相关性。方法:采用单克隆抗体四色直接免疫荧光标记AML骨髓细胞行流式细胞仪检测其免疫表型,回顾分析AML患者骨髓细胞免疫表型特点,并分析AML(除外M3)免疫表型与预后的关系。结果:510例AML免疫表型各抗原表达阳性率(以荧光阳性细胞≥20%为表达阳性)情况:CD13(86.3%)、CD33(79.4%)、HLA-DR(66.9%)、CD34(58.9%)、CD117(55.4%)、CD64(45.8%)、CD7(29.2%)、CD11b(23.4%)、CD56(18.9%)、CD10(12.5%)、CD15(11.6%)、CD2(8.7%)、CD19(8.5%)、CD14(8.4%)。M3患者CD34、HLA-DR阳性率显著低于非M3患者(P<0.01)。在AML(非M3)患者中,CD10、CD11b表达阳性或CD13、CD34高水平表达(以荧光阳性细胞≥50%为表达阳性)的患者CR率显著降低(P<0.05);CD13和CD34高水平表达和CD13/CD34共表达的患者中位生存期显著缩短(P<0.05)。结论:CD13、CD33、HLA-DR、CD34、CD117是AML最常见的表达阳性抗原,CD10、CD11b、CD13及CD34的表达状况与AML(非M3)患者预后相关。免疫表型分析不仅有助于疾病的诊断,而且对急性髓系白血病的预后判断有着重要的价值。
Objective: To investigate the immunophenotypic characteristics of acute myeloid leukemia (AML) and its relationship with prognosis. Methods: The immunophenotypes of AML bone marrow cells were detected by flow cytometry with four-color direct immunofluorescence staining of monoclonal antibodies. The immunophenotypic characteristics of bone marrow cells in AML patients were retrospectively analyzed. The immunophenotypes of AML (except M3) and prognosis relationship. Results: The positive rate of each antigen expression in 510 AML cases (positive for fluorescent positive cells ≥20%) was CD13 (86.3%), CD33 (79.4%), HLA-DR CD117 (55.4%) CD64 (45.8%) CD7 (29.2%) CD11b (23.4%) CD56 (18.9%) CD10 (12.5%) CD15 (11.6% , CD19 (8.5%), CD14 (8.4%). The positive rate of CD34 and HLA-DR in M3 patients was significantly lower than that in non-M3 patients (P <0.01). In AML (non-M3) patients, the CR rate was significantly lower in patients with CD10, CD11b expression or high expression of CD13 and CD34 (positive than ≥50%) (P <0.05); high levels of CD13 and CD34 The median survival time was significantly shorter in patients with CD13 / CD34 expression (P <0.05). Conclusion: CD13, CD33, HLA-DR, CD34 and CD117 are the most common positive antigens in AML. The expression of CD10, CD11b, CD13 and CD34 are correlated with the prognosis of AML patients. Immunophenotyping not only contributes to the diagnosis of the disease, but also plays an important role in the prognosis of acute myeloid leukemia.