急性髓系白血病免疫表型特征及遗传学特征分析

目的:研究急性髓系白血病免疫表型特征以及遗传学特征。方法:选取2011年1月到2014年5月我院收治的急性髓系白血病患者169例,采用流式细胞术和相关的单克隆抗体来分析所有患者的骨髓免疫表型,采用染G染色体显带技术分析患者的核型,根据淋系抗原(lym Ag)的表达将患者分为lym Ag+组和lym Ag-组。结果:抗原CD13、CD33、CD117以及MPO等髓系抗原最常在急性髓系白血病患者中表达,其中CD117在M3型病例中表达为85.7%(24/28),而CD34、HLA-DR双阴性、较强的自发荧光、CD13、CD33和MPO对M3型的诊断也具有一定的价值;其中47.9%(81/169)的患者伴随着淋系抗原表达,以CD7和CD56为主;60.4%(102/169)的患者伴随着核型异常;而伴随着t(8:21)的M2患者中的CD15、CD19和CD56的表达显著增强,而t(15:17)均发生于M3型患者中;而lym Ag+组患者CD34的阳性患者为77.8%(63/81)显著高于lym Ag-组的47.7%(42/88),两组比较差异具有统计学意义(P0.05)。结论:免疫表型对急性髓系白血病的诊断具有重要的意义,且免疫表型和异常核型存在密切的联系。

Analysis of Immunophenotype and Genetic Characteristics of AcuteMyeloid Leukemia

Objective:To study the immunophenotype and genetic characteristics of acute myeloid leukemia.Methods:169 casesof patients with acute myeloid leukemia from January 2011 to May 2014 in our hospital were selected, the bone marrowimmunophenotype was analyzede by flow cytometry and associated monoclonal antibodies and the patient''s karyotype was analyzed bystaining of G chromosome banding technique,the patients were divided into the lymAg+ group and lymAg- group according to lymphoidantigen (lymAg) expression.Results:The antigen CD13, CD33, CD117 and MPO myeloid antigen were always expressed in patientswith acute myeloid leukemia, the expression of CD117 in type M3 was 85.7% (24/28),while double negative expression of CD34 andHLA-DR, strong autofluorescence, expression of CD13, CD33 or MPO all had a certain value in the diagnosis of M3; 47.9%(81/169) ofpatients were lymphoid antigen positive, especially positive in CD7 and CD56; 60.4% (102/169) of patients were with abnormalkaryotype; CD15, CD19 and CD56 increased significantly in M2 patients witht (8:21) expression, whilet (15:17) occurred in the type M3patients; D34 positive patients accounted for 77.8% (63/81) in lymAg+ group, significantly higher than 47.7% (42/88) of the lymAggroup(P<0.05).Conclusion:The immune phenotype play an important role in the diagnosis of acute myeloid leukemia,theimmunophenotype has a close relationship with abnormal karyotype.