摘要
目的探讨流式细胞分析对于急性白血病免疫分型的临床指导意义。方法选择2015年10月至2016年10月本院收治的80例急性白血病患者,男43例,女37例,年龄30～72岁,平均(47.5±7.3)岁;急性髓系白血病(acutemyelocyticleukemia,AML)56例,B系急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)24例;AML患者FAB分型M0 4例、M_1 3例,M_2 18例、M_3 9例、M_4 5例、M_4EO 5例、M_5 7例、M_6 1例、M_7 4例,ALL患者FAB分型L_1型15例、L_2型8例,L_3型1例。采用四色荧光流式细胞术检测骨髓细胞表面标识分子的表达。结果以CD45/SSC设门进行流式细胞检测,结果显示CD45表达水平从低到高依次为成熟粒细胞<原幼细胞<单核细胞<淋巴细胞,细胞颗粒表达从低到高依次为红细胞<淋巴细胞<原幼细胞<单核细胞<成熟粒细胞。AML患者中,M_1高表达CD13,M_2高表达CD13、CD56,M_3高表达CD10、CD20,M_5高表达CD13、CD56,AML患者总体高表达CD13、CD56、CD10;ALL患者中,L_2型高表达CD19,L_1型表达高CD10、CD19、CD13,ALL患者总体高表达CD10、CD19、CD13。首次化疗后患者病情完全缓解率为83.75%,有13例患者未达到完全缓解,其中3例患者出现明显的免疫标记、6例为CD7阳性。治疗后随访过程中,28例患者死亡,包括AML患者19例,ALL患者9例,其中因交叉感染死亡11例,伴CD7高表达6例。结论采用流式细胞术对急性白血病患者进行免疫表型分析,对疾病诊断及预后评估有积极的临床意义。
Objective to study the analysis of flow cytometry to clinical guiding significance in immune classification of acute leukemia. Method Of 40 patients with acute leukemia were accepted in our study, a four-color fluorescence FCM detecting its marrow cell surface marks. Result Set door CD45/SSC test cell, antigen CD45 cells into mature granulocytes monocyte the young cells lymphocytes; Cell particles are characterized by red blood cells lymphocyte monocyte the young cells mature granulocytes; High expression of CD13, M1 M2 high express CD13 and CD56, M3 high expression of CD10 and CD20, M5 high expression of CD13 and CD56, total cells antigens in patients with high expression of CD13, CD56 and CD10;ALL cases, the antigen expression L2 high expression of CD19, L1 expressed higher for CD10, CD19 and CD13, total cells antigens in patients with high expression of CD10, CD19 and CD; Chance for the first time after chemotherapy patients complete remission（83.75%）, in addition, there are 13 cases of patients with CR has not been achieved, including 3 cases of patients with obvious immune markers, 6 cases of CD7 positive. Follow-up, after treatment with 28 patients with death, 19 cases of patients with AML（67.86%）, ALL have 9 cases（32.14%）, including death from cross infection in 11 cases, with CD7 high expression in 6 cases（54.55%）. Conclusion The pathological changes and immune, phenotype of patients with acute leukemia have their respective characteristics. It is of positive clinical significance to analyze the immune, phenotype of patients with acute leukemia by flow cytometry.
作者
汪梅花
赵康
WANG Mei-hua;ZHAO Kang(Department of Hematology and Immunology,Yan＇an University Affiliated Hospital,Shaanxi Yan＇an 716000,China)
出处
《中国医刊》
CAS
2018年第11期1233-1235,共3页
Chinese Journal of Medicine
关键词
急性白血病
流式细胞术
免疫分型
临床意义
Acute leukemia
Flow cytometry
Immune classification
Clinical significance
