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形態學分型困難的白血病24例免疫分型
作者：孫英慧，馬東初，藺迪，于卉影，時葆賦,陸巖【關鍵詞】 白血病；免疫分型；流式細胞儀
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： 應用流式細胞儀對24例臨床形態學診斷困難的急慢性白血病進行快速、有效地免疫分型，以指導臨床化療. 方法： 采用單克隆抗體雙色直接免疫熒光標記法及多參數流式細胞術（FCM），分型根據抗體積分系統，并與FAB分型進行比較. 結果： ① 9例臨床診斷慢性淋巴細胞白血病經FCM免疫分型確診為B淋巴細胞性白血病；② 5例臨床診斷急性淋巴細胞白血病（L2）的患者經FCM免疫分型確診1例為B淋巴細胞性白血病；2例為T淋巴細胞性白血病，且1例伴紅系異常改變； 1例為未分化型白血病；1例為淋巴細胞白血病B，T雙表達；③ 5例急性非淋巴細胞性白血病經FCM免疫分型確診2例為髓系白血病；3例為紅白血病（M6）；④ 1例MDS伴骨髓纖維化經FCM免疫分型確診為M6；⑤ 4例疑似粒淋雙表型白血病經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%. 結論： 流式細胞儀多參數白血病免疫表型分析，可以彌補FAB分型的不足，為臨床診斷提供重要依據，并為白血病治療措施的個體化提供依據.
【關鍵詞】 白血病；免疫分型；流式細胞儀
0引言
白血病是造血系統的惡性腫瘤，在形態上變化雖相當大，但仍能表達正常血細胞所具有的抗原，因而可依據其抗原的表達譜對白血病進行免疫分型. 我們對24例臨床確診為急慢性白血病，但形態學分型較困難的患者，應用流式細胞儀對其進行了免疫分型，并與FAB分型進行了比較.
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標記的
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