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目的探讨CD64在急性白血病免疫分型中的意义。方法应用直接荧光标记法,经流式细胞术对116例急性髓系白血病(AML)和70例急性淋巴细胞白血病(ALL)进行免疫表型的检测。结果 AML组CD64的表达阳性率明显高于ALL组(41.4%vs 2.9%,P<0.01)。CD64在M5和M4的表达阳性率最高,分别为77.1%和55.6%。CD64的阳性表达率在M0(0)、M1(0)、M2(7.9%)明显低于M3(47.1%)、M4与M5(P<0.01)。各亚型CD64阳性病例中,M4、M5的CD64阳性细胞表达率分别为(62.5±24.7)%、(68.7±25.9)%,均明显高于M2(28.3%±5.7%)、M3(34.3%±6.3%)(P<0.01)。CD64对诊断AML的灵敏度优于CD14,其特异度优于CD117、CD33及CD13。虽然CD64诊断M4M5的特异度较CD14稍差(82.5%vs 100%),但是灵敏度高于CD14(69.8%vs 41.5%)。结论 CD64可作为辅助诊断AML的髓系标志抗原,有助于提高M4/M5的检出率及其与其他AML亚型的鉴别诊断。
Objective To investigate the significance of CD64 in the immunophenotyping of acute leukemia. Methods The direct immunofluorescence method was used to detect the immunophenotype of 116 acute myeloid leukemia (AML) and 70 acute lymphoblastic leukemia (ALL) by flow cytometry. Results The positive rate of CD64 in AML group was significantly higher than that in ALL group (41.4% vs 2.9%, P <0.01). The positive rates of CD64 expression in M5 and M4 were 77.1% and 55.6% respectively. The positive expression rates of CD64 in M0 (0), M1 (0) and M2 (7.9%) were significantly lower than those in M3 (47.1%) and M4 and M5 (P <0.01). The positive rates of CD64 positive cells in M4 and M5 were (62.5 ± 24.7)% and (68.7 ± 25.9)%, respectively, which were significantly higher than those in M2 (28.3% ± 5.7%) and M3 ± 6.3%) (P <0.01). The sensitivity of CD64 to diagnosing AML is better than that of CD14, its specificity is better than that of CD117, CD33 and CD13. Although the specificity of CD64 diagnosis of M4 M5 was slightly worse than that of CD14 (82.5% vs 100%), the sensitivity of CD64 was higher than that of CD14 (69.8% vs 41.5%). Conclusion CD64 can be used as a diagnostic marker for myeloid leukemia in AML, which can help improve the detection rate of M4 / M5 and its differential diagnosis with other AML subtypes.