摘要
为探讨形态学、免疫学、细胞遗传学联合检测对急性白血病 (AL )诊断、治疗、预后判断等方面的临床意义 ,对初诊为 AL 的 39例患者分别进行了骨髓细胞形态学、免疫学及染色体检测 ,并按照 FAB标准进行形态学 (组织化学染色 )分型 ;采用间接免疫荧光法标记活细胞膜表面分化抗原 (CD)进行免疫学分型 ;采用 2 4小时培养法制备染色体标本 ,G带显示法进行染色体检查。结果 :39例患者经形态学检查确诊为 AL ,其中急性淋巴细胞白血病 (AL L) 8例 ,急性非淋巴细胞白血病 (ANL L) 2 9例 ,2例难以分型 ;免疫学诊断为 AL L8例 (其中 2例伴髓系抗原表达 ) ,ANL L 2 9例 (其中 4例伴淋巴细胞抗原表达 ) ,2例形态学难以分型者 ,诊断为急性杂合性白血病。免疫学与形态学分型符合率 94 .9% (37/ 39)。39例中染色体核型异常 18例。本研究结果还显示 ,经临床治疗后染色体复杂畸形者缓解率低 ,正常核型及某些染色体核型 [如 t(15 ;17) ]者缓解率较高。认为形态学、免疫学、细胞遗传学联合检测可提高 AL诊断的准确性 。
To investigate the clinical significance in diagnosis,treatment and prognostic judgments of acute leukemia(AL)with combined detection of morphology, immunology and cytogenetics. Morphologic typing and immunophenotyping were carried out in 39 untreated patients with acute leukemia respectively with FAB criteria and indirect immunofluorescence stain which was used to label surface differential antigen of living cell membrane. Chromosomal specimen were prepared by 24-hour culture method. Chromosomal examination was performed with G-band display technique. Results showed that All the 39 patients were diagnosed to have acute leukemia by morphology and histochemical stain, 8 of whom suffered from acute lymphocytic leukemia(ALL), 29 of whom had acute non-lymphocytic leukemia(ANLL),and 2 of whom could not be classified.Diagnosis by immunology was established in 8 cases of ALL(2 of them had myelogenous antigen expression).Diagnosis by immunology was established in 29 cases of ANLL(4 of whom had lymphocytic antigen expression). Diagnosis failed to be confirmed in 2 out of 39 patients with morphology.The 2 patients were diagnosed to heterozygous leukemia with immunology. The accordant rate of immunology and FAB typing was 94.9%(37/39). Among the 39 patients chromosomal karyotype abnormality was found in 18 cases. Low remission rate occurred in the patients with complex chromosomal deformity. High remission rate was present in the normal karyotype and such chromosomal karyotypes as t (15;17).It is concluded that the accuracy of AL diagnosis could be raised with combined detection of morphology, immunology and cytogenetics. It would contribute to establishment of the therapeutic plan and prognostic judgments.
出处
《山东医药》
CAS
北大核心
2003年第17期7-9,共3页
Shandong Medical Journal
