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目的研究急性早幼粒细胞白血病(APL)表型特征及临床意义。方法采用流式细胞术四色方案对APL进行免疫分型,以CD45/SSC-lin图定位白血病细胞,依据抗原表达强度将抗原表达划分为五级分析。结果典型APL细胞抗原表达强度及所占比例依次为:CD33(100%)、髓过氧化物酶(MPO)100%、CD38(82.35%)、CD13(64.71%)、CD64(50%)、CD123(47.06)、CD117(44.12%),HLA-DR和CD34基本不表达;伴淋系表达APL患者化疗后缓解率明显低于阴性APL患者。结论 APL免疫分型典型表型特征为高侧向角散射(high SSC)、CD33~+(Ⅰ级)、CD38~+(Ⅰ级)、MPO~+(Ⅰ级)、CD13~+(Ⅲ级)、CD64~+(Ⅰ级/Ⅲ级)、CD117~+(Ⅱ级/Ⅲ级/Ⅳ级)、CD123~+(Ⅲ级/Ⅳ级)、CD11b~-、HLA-DR~-、CD34~-。掌握APL免疫表型特征有助于APL快速诊断,且对MRD检测有指导意义。
Objective To study the phenotype and clinical significance of acute promyelocytic leukemia (APL). Methods The four-color flow cytometry was used to immunophenotype APL. The leukemic cells were located on the CD45 / SSC-lin map. Antigen expression was divided into five levels according to the antigen expression intensity. Results The expression intensity of typical APL antigen and its proportion were as follows: CD33 (100%), myeloperoxidase (MPO) 100%, CD38 (82.35%), CD13 (64.71%), CD64 (47.06), CD117 (44.12%), but not HLA-DR and CD34. The response rate of APL patients with lymph node metastasis after chemotherapy was significantly lower than that of negative APL patients. Conclusion The typical phenotypes of APL immunophenotyping are high SSC, CD33 ~ + level Ⅰ, CD38 ~ + level Ⅰ, MPO ~ + level Ⅰ, CD13 ~ + level Ⅲ ), CD11b ~ -, HLA-DR ~ -, CD34 ~ +, CD114 ~ +, CD117 ~ + Ⅱ / Ⅲ / Ⅳ) -. To master the APL immunophenotypic features contributes to the rapid diagnosis of APL, and has instructive significance for MRD detection.