论文部分内容阅读
目的探讨慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)免疫分型和细胞遗传学特点。方法 56例CLL患者采用多参数流式细胞术进行免疫分型,采用荧光原位杂交技术行细胞遗传学特点分析。结果 56例CLL患者成熟B细胞相关抗原CD5、CD19、CD20、CD22及CD23高表达,T系相关抗原CD3、CD4、CD8低表达,早期造血标志人白细胞DR抗原(HLA-DR)和CD38阳性率分别为100.0%和32.1%,ZAP-70和FMC7阳性率分别为19.6%和8.9%;在Binet分期中,B期和C期CD38阳性抗原表达(41.1%,36.0%)明显高于A期(14.3%)(P<0.05);56例CLL患者中,38例至少有1种遗传学异常,12例有2种及2种以上遗传学异常;发现4种遗传学异常,依次为13q14基因缺失(42.8%)、+12(21.4%)、17p13基因缺失(12.5%)、atm基因缺失(10.7%),其中2例有2条染色体缺失(nulll3q14),异常细胞率分别为56.3%、69.3%;CD38≥30%组+12异常率(38.9%)和atm基因缺失发生率(27.8%)均明显高于CD38<30%组(13.2%,2.6%)(P<0.05);细胞遗传学异常在性别、年龄、Binet分期、血清乳酸脱氢酶水平和ZAP-70表达水平上差异均无统计学意义(P>0.05)。结论 CLL免疫表型主要表达CD5、CD19、CD20、CD23;荧光原位杂交技术是一种检测CLL患者细胞遗传异常快速、准确和敏感的方法。
Objective To investigate the immunophenotype and cytogenetic characteristics of chronic lymphocytic leukemia (CLL). Methods Fifty-six patients with CLL were immunophenotyped by multi-parameter flow cytometry. Cytogenetic characteristics were analyzed by fluorescence in situ hybridization. Results The positive expression of CD3, CD19, CD20, CD22 and CD23 on mature B cells in 56 CLL patients was high, the expression of CD3, CD4 and CD8 on T lymphocytes was low, the positive rate of HLA-DR and CD38 Respectively. The positive rates of ZAP-70 and FMC7 were 19.6% and 8.9%, respectively. The positive rates of CD38 positive antigen (41.1%, 36.0%) in stage B and C were significantly higher than those in stage A 14.3%) (P <0.05). Among 56 CLL patients, 38 had at least one genetic abnormality and 12 had two or more genetic abnormalities. Four genetic abnormalities were found, which were the deletion of 13q14 gene (42.8%), +12 (21.4%), 17p13 gene deletion (12.5%), and atm gene deletion (10.7%). There were 2 null null3q14 in 2 cases and 56.3% ; The incidence of +12 abnormality rate (38.9%) and atm gene deletion (27.8%) in CD38≥30% group was significantly higher than that in CD38 <30% (13.2%, 2.6%) (P <0.05); cytogenetic abnormality There were no significant differences in gender, age, Binet stage, serum lactate dehydrogenase level and ZAP-70 expression level (P> 0.05). Conclusion CLL immunophenotype mainly expresses CD5, CD19, CD20 and CD23. Fluorescence in situ hybridization is a rapid, accurate and sensitive method to detect cytogenetic abnormalities in CLL patients.