185例儿童急性白血病流式细胞术免疫分型研究

目的：探讨儿童急性白血病流式细胞术免疫分型的意义。方法：采用流式细胞术三色荧光标记技术和CD45／SSC双参数散点图设门，检测185例儿童急性白血病的免疫表型，对抗原表达情况进行分析。结果：流式细胞术免疫分型和FAB分型的符合率为89．19％。185例儿童急性白血病中，ALL为121例，占AL的65．41％，B—ALL为113例，主要表达B系的CD19（99．12％）、CD22（98．13％）、CD79a（96．19％）、CD10（86．73％）。T—ALL占8例；主要表达CD5（100％）、CD7（100％）、cCD3（100％）、CD8（87．5％）。AML为47例，占25．41％，主要表达CD33（93．62％）、CD15（78．72％）、CD64（76．6％）、MPO（76．6％）、CD13（74．47％）。在B—ALL，AML，T—ALL中，敏感性最高的抗体分别是CD19，CD33，CD5和CD7，特异性最强的抗体分别是CD79a，MPO，cCD3。AMLL为17例，占9．19％，其中B／M为9例，T／B为5例，T／M为3例。My＋-ALL为54例，占ALL的44．63％，表达的髓系抗原为CD13、CD15、CD33、CD64。Ly＋-AML为18例，占AML的38．30％，表达的淋系抗原为CD19、CD4、CD7。系列非相关抗原CD34的表达率为67．57％，HLA—DR的表达率为85．41％，CD38的表达率为80．59％，TdT的表达率为62．59％。结论：流式细胞术免疫分型在白血病分型中起重要作用，是FAB分型的补充和修正，提高了儿童急性白血病诊断的准确率。有必要进一步加强流式细胞术免疫分型的标准化工作。

Immunophenotyping of 185 Children with Acute Leukemia by Flow Cytometry

Objective： To investigate the significance of immunophenotype in children＇s acute leukemia via flow cytometry. Methods： Immunophenotypes were detected by three-color flow cytometry （FCM） and CD45/SSC gating in 185 cases of acute leukemia （AL） and antigentic expressions were analysed. Results： The coincidence rate was 89.19% between FAB and immunophenotype. Among the 185 cases of AL, 121 （65.41%） were acute lymphoblastic leukemia （ALL）.In 113 cases of B-lineage ALL （B-ALL）, CD 19 （ 99.12% ）, CD22（98.13%） , CD79a（96.19%）, CD10（86.73% ）agents had high expression. CD19 was the most sensitive and CD79a was the most intense in specificity. In 8 cases of T-ALL, CD5 （ 100% ）, CD7 （ 100% ）, cCD3 （ 100% ）, CD8 （87.5%）agents had higher expression in T lymphoblastic, CD5 and CD7 were the most sensitive, cCD3 was the most intense in specificity./n AML, CD33 was high sensitivity and MPO was specificity. Myeloblastic agents were often expressed as follows： CD33 , CD15 ,CD64 , MPO , CD13 in the order of decreasing. 17 cases were acute mixed lineage leukemia, 9 cases were B/M, 5 cases were T/B and 3 case were T/M.My＋-ALL made up 44.63% of ALL express such myeloid antigens as CD13, CD15, CD33, CD64. 18 cases were Ly＋-AML, in which CD19,CD4 and CD7 were chiefly presented Lymphoid lineage associated antigents. The unlineage-associated antigens expression frequencies were as follows： CD34 （67.57%）,HLA-DR （85.41%）,CD38 （80.59%）,TdT （62.59%）. Conclusion： Immunophenotype plays an important role in the classification of children＇s acute leukemia and is a supplementary and correction of FAB phenotype. It can enhance the exactness of diagnosis and needs to be standardized.