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目的研究成人急性淋巴细胞白血病(ALL)患者中不同亚型的各种白血病细胞免疫表型分布特点。方法采用当前国际通用的四色流式细胞术图像分析系统检测并综合分析76例ALL患者的免疫表型及其发生规律与特点。结果①76例ALL免疫表型系列来源可分为三种不同亚型,其中T-ALL亚型5例(占6.57%)、B-ALL亚型68例(89.48%)、T和B细胞混合型(T/B-ALL)亚型3例(3.95%)②ALL早期抗原表达特点:在B-ALL亚型中CD38、CD34、HLA-DR呈高表达;在T-ALL亚型中,CD38和CD34呈高表达,但HLA-DR不表达;在T/B-ALL亚型中,HLA-DR表达,CD34和CD38不表达。③按免疫分型相关抗原的敏感性和特异性分析:在B-ALL中,特异性抗原cCD79a占91.18%,敏感性抗原CD19表达占97.06%;在T-ALL中,特异性抗原cCD3和敏感性抗原CD7均表达为100%;在T/B混合型ALL中,cCD3、cCD79a、CD19均表达,CD7表达2例;④伴髓系抗原交叉表达分析:在B-ALL中,伴髓系抗原表达占21例(30.88%);在T-ALL中,伴髓系抗原表达1例(20%);T/B-ALL中无伴髓系单抗表达;结论ALL的三种不同亚型中,免疫表型系列相关抗原的表达、早期抗原表达和交叉表达有着不同的特点,为临床ALL的诊断预后和个体化治疗提供了参考依据。
Objective To investigate the immunophenotypic distribution of various leukemia cells in different subtypes of adults with acute lymphoblastic leukemia (ALL). Methods The current international four-color flow cytometry image analysis system to detect and comprehensive analysis of 76 cases of ALL patients with immune phenotype and its occurrence and characteristics. Results There were three different subtypes of 76 ALL immunophenotypes, including 5 T-ALL subtypes (6.57%), 68 B-ALL subtypes (89.48%), T and B cell mixed type (T / B-ALL) subtype in 3 cases (3.95%) ② The characteristics of early antigen expression in BAL: CD38, CD34 and HLA-DR were highly expressed in B-ALL subtypes; But HLA-DR was not expressed. In T / B-ALL subtypes, HLA-DR was expressed but not CD34 and CD38. ③According to the sensitivity and specificity analysis of immunophenotype-related antigens: in B-ALL, the specific antigen cCD79a accounted for 91.18%, the sensitivity antigen CD19 expression accounted for 97.06%; in T-ALL, the specific antigen cCD3 and sensitive The expression of CD7 was all 100% in T / B mixed ALL, cCD3, cCD79a and CD19 were both expressed in CD9 and CD7 in 2 cases. (4) Cross-analysis of myeloid antigens: In B-ALL, There were 21 cases (30.88%) in T-ALL, 1 case (20%) with myeloid antigen expression in T-ALL, and none in T / B-ALL. , The expression of immunophenotype related antigen series, early antigen expression and cross-expression have different characteristics, which provide a reference for the diagnosis and prognosis and individualized treatment of clinical ALL.