直接免疫荧光法分析白血病及骨髓增生异常综合征患者免疫表型

目的 :检测急性白血病 (AL)及骨髓增生异常综合征 (MDS)免疫表型及其临床意义。方法 :用流式细胞仪CD4 5设门直接免疫三标记法 ,检测 4 9例AL及MDS患者免疫表型。结果 :ALL双克隆型 9例 ,其中髓系伴T -ALL 3例 ,髓系伴B -ALL 4例 ,1例为髓系伴T、B标记 (CD13 +CD7+CD19+ ) ,1例同时CD7+CD19+ ;ALL同时表达CD3 4 及HLA -DR最高 (6 0 .0 1%) ,明显高于AML、MDS(P <0 .0 0 5 )。AML双克隆型 2 0例 ,7例为髓系伴CD7+ ,2例髓系伴CD19+ ,11例为同时表达CD3 4 +HLA -DR +。MDS患者骨髓细胞表达髓系成熟抗原CD13 +及CD3 3 +增高 ,未发现淋系抗原的表达。MDS -RAEB、RAEBT及转为白血病病例均高表达CD3 4 及HLA -DR抗原。结论 :用三标记法简便易行 ,提高诊断准确性 ;单抗组合应兼顾髓、淋系同时表达 ;应加胞浆抗原检测。

Analysis of immunophenotypes in patients with leukemia and myelodysplastic syndrome by direct immunofluoresence

Aim: To analyze the immunophenotypes of acute leukemia(AL) and myelodysplastic syndroms(MDS) and their clinical significance. Methods: Examined the immunophenotypes of 49 cases of AL and MDS patients using three markers with CD 45 gated direct immunofluoresence methods by flow cytometry. Results: 9 cases of biclonal types in ALL were found, among which 3 cases myeloid antigens with T antigens coexpression,4 cases myeloid antigens with B antigens coexpression, 1 case myeloid antigens with T and B antigens coexpression(CD 13+CD 7+CD 19+),1 case with CD 7+CD 19+ coexpression;CD 34 and HLA-DR coexpression in ALL is significantly higher than in AML?MDS(60.01%,P<0.005). 20 cases of biclonal types in AML were found, among which 7 cases myeloid antigens with CD 7 coexpression,2 cases myeloid antigens with CD 19 coexpression,11 cases CD 34+HLA-DR+ coexpression. Mature myeloid antigens CD 13 and CD 33 expressions in MDS were high, while no lymphoid antigens expressions were found. CD 34 and HLA-DR expressions were high in MDS-RAEB?RAEBT and transformed AL. Conclusion: Three markers with CD 45 gated direct immunofluoresence methods were simple to perform and useful for diagnosis. Coexpressions of myeloid and lymphoid antigens should be paid more attention. Cytoplasmic antigens should be examined in AL and MDS.