论文部分内容阅读
目的探讨免疫分型在急性髓系白血病(AML)诊断、治疗、预后中的意义。方法回顾性分析169例已确诊的AML患者的细胞形态学与免疫表型结果。免疫表型分析采用CD45、侧向角光散射双参数散点图设门,四色流式细胞术,对169例AML患者用20种荧光标记单克隆抗体(McAb)测定白血病细胞的抗原表达。结果①形态学分型与最终诊断符合率为89.3%,免疫分型与最终诊断符合率为88.8%,二者联合应用分析与最终诊断符合率为97.1%。②CDⅡ7、CDⅠ3、CD33在AML各型中高表达;CDⅠ4、CD64、CD4在M4、M5中高表达;CD34及HLA-DR在M3中低表达;淋系抗原在AML患者中也有阳性表达,其中CD7表达率最高,占20.2%;CD7(+)与CD7(-)的完全缓解率(CR)比较差异有统计学意义(P<0.05)。结论 AML患者白血病细胞抗原表达复杂,应多个抗原综合分析;细胞形态学分型与流式细胞术免疫分型的联合应用检测可提高临床诊断与分型的准确性。淋系抗原在急性髓系白血病患者中也有阳性表达,其中CD7表达率最高,伴有CD7+的AML患者CR率低于CD7-的AML患者。
Objective To investigate the significance of immunophenotyping in the diagnosis, treatment and prognosis of acute myeloid leukemia (AML). Methods The morphological and immunophenotypic results of 169 confirmed AML patients were retrospectively analyzed. Immunophenotypic analysis of anti-leukemia cell antigen expression using CD45, lateral angle light scattering two-parameter scatter plot gate, four-color flow cytometry in 169 cases of AML patients with 20 kinds of fluorescent labeled monoclonal antibody (McAb). Results ① The coincidence rate of morphology and final diagnosis was 89.3%. The coincidence rate of immunophenotyping and final diagnosis was 88.8%. The coincidence rate of the two methods was 97.1% with the final diagnosis. CDⅡ, CDⅠ3 and CD33 were highly expressed in all AML types; CDⅠ4, CD64 and CD4 were highly expressed in M4 and M5; CD34 and HLA-DR were low expressed in M3; lymphoid antigen was also expressed in AML patients, (20.2%). The complete remission rate (CR) between CD7 (+) and CD7 (-) was significantly different (P <0.05). Conclusions The expression of leukemia antigen in AML patients is complex and multiple antigen analysis should be performed. The combination of cell morphological typing and flow cytometry immunophenotyping can improve the accuracy of clinical diagnosis and typing. Lymphoid antigens are also expressed in patients with acute myeloid leukemia, of which the highest expression of CD7, CD7 + AML patients with CR rate lower than CD7- AML patients.