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目的研究成人急性白血病免疫分型及与预后的关系。方法以CD45/SSC双参数散点图设门,采用流式细胞术检测106例成人急性白血病患者免疫分型情况。结果(1)71例急性髓系白血病(AML)患者主要表达CD13、CD33、HLA-DR、CD34和CD117抗原,23.9%的AML患者伴有淋系抗原表达,15.5%的AML病人伴有CD56抗原的表达。(2)29例急性淋巴细胞白血病(ALL)患者主要表达HLA-DR、CD10、CD19、CD34和CD7,34.5%的ALL患者伴有髓系抗原的表达。(3)伴有淋系抗原表达的AML患者化疗完全缓解(CR)率为52.9%(9/17),显著低于未伴有淋系抗原表达的AML病人(77.8%)(P<0.05);伴有髓系抗原表达的ALL患者化疗后CR率为70.0%,而未伴有髓系抗原表达的ALL患者CR为94.7%,两者差异无显著性(P>0.05);CD56+AML患者化疗后CR率仅36.4%,显著低于CD56- AML患者(78.3%)(P<0.025);CD34+ AML患者化疗后CR率为56.0%,显著低于CD34- AML患者(80.4%)(P<0.05)。结论采用CD45和SSC双标记设门可较好地排除正常骨髓细胞的影响,较准确地反映病人的免疫学分型;伴淋巴系抗原表达的AML、CD56+ AML及CD34+ AML化疗后CR率低,预后差。
Objective To study the immunophenotyping of adult acute leukemia and its relationship with prognosis. Methods The CD45 / SSC double-parameter scatter plot was used to determine the immunophenotype of 106 adult patients with acute leukemia by flow cytometry. Results (1) 71 cases of acute myeloid leukemia (AML) patients mainly expressed CD13, CD33, HLA-DR, CD34 and CD117 antigen, 23.9% of AML patients with lymphoid antigen expression, 15.5% of AML patients with CD56 antigen expression. (2) 29 cases of acute lymphoblastic leukemia (ALL) patients mainly express HLA-DR, CD10, CD19, CD34 and CD7, 34.5% ALL patients with myeloid antigen expression. (3) The complete remission (CR) rate of chemotherapy in AML patients with lymphoid antigen expression was 52.9% (9/17), significantly lower than that of AML patients without lymphoid antigen expression (77.8%) (P <0.05) ; The CR rate of ALL patients with myeloid antigen expression after chemotherapy was 70.0%, while that of patients without myeloid antigen expression was 94.7%, there was no significant difference (P> 0.05); CD56 + AML patients The CR rate after chemotherapy was only 36.4%, significantly lower than that of CD56-AML patients (78.3%) (P <0.025). The CR rate of CD34 + AML patients after chemotherapy was 56.0%, significantly lower than that of CD34- AML patients (80.4% 0.05). Conclusion The double-labeled CD45 and SSC double-labeled gates can well exclude the influence of normal bone marrow cells and accurately reflect the immunological typing of patients. The rates of CR, AML, CD56 + AML and CD34 + AML with lymphoid antigen expression are low, the prognosis difference.