形態(tài)學(xué)分型困難的白血病24例免疫分型

作者：孫英慧，馬東初，藺迪，于卉影，時(shí)葆賦,陸巖
【關(guān)鍵詞】 白血��；免疫分型；流式細(xì)胞儀
　　Immunophenotyping in 24 patients with leukemia in comparison with morphotyping
　　【Abstract】 AIM: To study the immunophenotyping with flow cytometry rapidly and efficiently in 24 patients with acute or chronic leukemia. METHODS: Immunophenotyping was performed by doublelabeling with different antibodies conjugated with FITC and PE and analyzed with multiparameter flow cytometry for 24 patients with acute or chronic leukemia, which were difficult to be diagnosed clinically by morphology. RESULTS: ① Nine patients clinically diagnosed as chronic lymphocytic leukemia were immunophenoyped as B lymphocytic leukemia by FCM; ② Five patients clinically diagnosed as acute lymphocytic leukemia (L2) were immunophenotyped as different leukemia groups by FCM, including 1 patient with B lymphocytic leukemia, 2 with T lymphocytic leukemia (one of them with erythrocytic abnormity), 1 with undifferentiated leukemia, and 1 with lymphocytic leukemia expressing both B and T cell antigens; ③ Five patients clinically diagnosed as acute nonlymphocytic leukemia were immunophenotyped by FCM as 2 patients with myeloid leukemia, 3 patients with erythroleukemia (M6); ④ One patient clinically diagnosed as MDS with myelofibrosis was immunophenotyped as M6 by FCM; ⑤ Among 4 patients who were suspected as both myeloid and lymphoidlineage phenotype, only 2 were diagnosed as double myeloid and lymphoid markers positive phenotype. The coincidence between immunophenotype ane FAB phenotype was 79.2%. CONCLUSION: Immunophenotyping by FCM may retrieve the faults of FAB phenotyping, providing important evidences for clinical diagnosis and guiding treatment individually.
　　【Keywords】 leukemia; immunophenotype; flow cytometry
　　【摘要】 目的： 應(yīng)用流式細(xì)胞儀對24例臨床形態(tài)學(xué)診斷困難的急慢性白血病進(jìn)行快速、有效地免疫分型，以指導(dǎo)臨床化療. 方法： 采用單克隆抗體雙色直接免疫熒光標(biāo)記法及多參數(shù)流式細(xì)胞術(shù)（FCM），分型根據(jù)抗體積分系統(tǒng)，并與FAB分型進(jìn)行比較. 結(jié)果： ① 9例臨床診斷慢性淋巴細(xì)胞白血病經(jīng)FCM免疫分型確診為B淋巴細(xì)胞性白血病；② 5例臨床診斷急性淋巴細(xì)胞白血�。↙2）的患者經(jīng)FCM免疫分型確診1例為B淋巴細(xì)胞性白血�。�2例為T淋巴細(xì)胞性白血病，且1例伴紅系異常改變； 1例為未分化型白血��；1例為淋巴細(xì)胞白血病B，T雙表達(dá)；③ 5例急性非淋巴細(xì)胞性白血病經(jīng)FCM免疫分型確診2例為髓系白血病；3例為紅白血�。∕6）；④ 1例MDS伴骨髓纖維化經(jīng)FCM免疫分型確診為M6；⑤ 4例疑似粒淋雙表型白血病經(jīng)FCM免疫分型確診為粒淋雙表型白血病. 免疫分型與FAB分型的符合率為79.2%. 結(jié)論： 流式細(xì)胞儀多參數(shù)白血病免疫表型分析，可以彌補(bǔ)FAB分型的不足，為臨床診斷提供重要依據(jù)，并為白血病治療措施的個(gè)體化提供依據(jù).
　　【關(guān)鍵詞】 白血��；免疫分型；流式細(xì)胞儀
　　0引言
　　白血病是造血系統(tǒng)的惡性腫瘤，在形態(tài)上變化雖相當(dāng)大，但仍能表達(dá)正常血細(xì)胞所具有的抗原，因而可依據(jù)其抗原的表達(dá)譜對白血病進(jìn)行免疫分型. 我們對24例臨床確診為急慢性白血病，但形態(tài)學(xué)分型較困難的患者，應(yīng)用流式細(xì)胞儀對其進(jìn)行了免疫分型，并與FAB分型進(jìn)行了比較.
　　1材料和方法
　　1.1材料白血病患者的骨髓24（男11，女13）例，年齡17～67（平均44）歲. 所用單抗包括FITC標(biāo)記的

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