B—ALL与T—ALL免疫分型特征探讨(1)
[摘要] 目的 研究50例急性淋巴细胞白血病(ALL)流式免疫分型结果，探讨CD19、CD22、CD38、CyCD79a、CD7、CyCD3等白细胞分化抗原在急性淋巴细胞白血病临床免疫分型中的意义。 方法 对50例初诊确诊为急性淋巴细胞性白血病患者的骨髓细胞进行流式细胞术免疫分型检测，采用CD45及SSC双参数设门，胞浆抗原(CyCD79a、CyCD3)以细胞膜表面抗体表型≥20%判定为该抗体表达阳性，以细胞浆抗体表型≥10%判定为该抗体阳性表达。 结果 34例急性B淋巴性白血病中敏感性及特异性高的抗原分别为CD19(100.0%)和CyCD79a(100.0%)；16例急性T淋巴性白血病中敏感性及特异性高的抗原分别为CD7(100.0%)和CyCD3(100.0%)；CD10、CD34、HLA-DR、CD38等早期非特异性分化抗原标志在急性淋巴细胞性白血病表达频率均比较高。 结论 在ALL已经确诊的情况下，CD19和CyCD79a是确定B-ALL最重要的单克隆抗体，CyCD22是B淋巴细胞系列最具特异性单克隆抗体，但CyCD22的敏感性较低；CD7和CyCD3是确诊T淋巴细胞性白血病的最重要单克隆抗体。
[关键词] 免疫分型；流式细胞术；白血病；淋巴细胞；急性淋巴细胞性白血病
[中图分类号] R733.71 [文献标识码] B [文章编号] 1673-9701(2016)19-0113-03
[Abstract] Objective To explore the immunophenotypes of 50 cases with acute lymphoblastic leukemia(ALL) and to discuss the significances of leukocyte differentiation antigens including CD19， CD22， CD38， CyCD79a， CD7， and CyCD3 in the clinical immunophenotypes of ALL. Methods 50 patients with confirmed ALL at first visit were selected and immunophenotyping detection was conducted by flow cytometry to their bone marrow cells. Dual-parameters of CD45 and SSC were used for gating. Cytoplasmic antigens such as CyCD79a and CyCD3 were considered positive of antibody expression if cell membrane surface antibody phenotype≥20%， and the cytoplasmic autoantibodies were considered positive of antibody expression if the antibody phenotype≥10%. Results Antigens with high sensibility and specibility in 34 cases of B-ALL were CD19 (100.0%) and CyCD79a (100.0%)， while those in 16 cases of T-ALL were CD7(100.0%) and CyCD3 (100.0%). Early non-specific differentiation antigen markers such as CD10， CD34， HLA-DR， and CD38 were of high expression frequencies in both types of ALL. Conclusion With confirmed ALL， CD19 and CD79a are important monoclonal antibodies in determination of B-ALL， while CyCD22 is the most specific monoclonal antibody in B lymphocytes， but its sensibility is low. CD7 and CyCD3 are the most important monoclonal antibodies in determination of T-ALL.
[Key words] Immunophenotype； Flow cytometry； Leukemia； Lymphocyte； Acute lymphocytic leukemia
急性淋巴细胞白血病(ALL)是一种淋巴系克隆性起源，多能干细胞或早期的祖细胞突变而引起的造血系统恶性肿瘤。它是由于血细胞中，主要是淋巴细胞异常肿瘤性增殖，并在体内各组织、器官，如骨髓、肝、脾、淋巴结等脏器广泛浸润，外周血中白细胞有质和量的异常，红细胞和血小板数减少，导致贫血、出血、感染和浸润等征象的一种疾病。近年来，随着流式细胞术的发展，通过流式细胞术来分析白血病细胞的来源以及分化阶段，从而为白血病的诊断、治疗及预后及复发风险的判断提供了重要的参考信息。流式细胞术具有灵敏度高，可重复性好，一次能检测信息量大等特性，能准确地反映白血病的起源和生物学特性。
白血病免疫分型是利用荧光素标记的单克隆抗体作为分子探针，对骨髓和外周血中造血干细胞及其增殖分化、成熟过程中抗原的表达进行大量研究，多参数分析白血病细胞的细胞膜、细胞浆和细胞核的免疫表型，由此检测白血病细胞所属细胞系列和及分化程度。免疫分型使白血病的诊断更加客观、准确、可靠，对白血病的治疗及预后分析具有重要意义。, 百拇医药(林祥伟 张苏伟)
[关键词] 免疫分型；流式细胞术；白血病；淋巴细胞；急性淋巴细胞性白血病
[中图分类号] R733.71 [文献标识码] B [文章编号] 1673-9701(2016)19-0113-03
[Abstract] Objective To explore the immunophenotypes of 50 cases with acute lymphoblastic leukemia(ALL) and to discuss the significances of leukocyte differentiation antigens including CD19， CD22， CD38， CyCD79a， CD7， and CyCD3 in the clinical immunophenotypes of ALL. Methods 50 patients with confirmed ALL at first visit were selected and immunophenotyping detection was conducted by flow cytometry to their bone marrow cells. Dual-parameters of CD45 and SSC were used for gating. Cytoplasmic antigens such as CyCD79a and CyCD3 were considered positive of antibody expression if cell membrane surface antibody phenotype≥20%， and the cytoplasmic autoantibodies were considered positive of antibody expression if the antibody phenotype≥10%. Results Antigens with high sensibility and specibility in 34 cases of B-ALL were CD19 (100.0%) and CyCD79a (100.0%)， while those in 16 cases of T-ALL were CD7(100.0%) and CyCD3 (100.0%). Early non-specific differentiation antigen markers such as CD10， CD34， HLA-DR， and CD38 were of high expression frequencies in both types of ALL. Conclusion With confirmed ALL， CD19 and CD79a are important monoclonal antibodies in determination of B-ALL， while CyCD22 is the most specific monoclonal antibody in B lymphocytes， but its sensibility is low. CD7 and CyCD3 are the most important monoclonal antibodies in determination of T-ALL.
[Key words] Immunophenotype； Flow cytometry； Leukemia； Lymphocyte； Acute lymphocytic leukemia
急性淋巴细胞白血病(ALL)是一种淋巴系克隆性起源，多能干细胞或早期的祖细胞突变而引起的造血系统恶性肿瘤。它是由于血细胞中，主要是淋巴细胞异常肿瘤性增殖，并在体内各组织、器官，如骨髓、肝、脾、淋巴结等脏器广泛浸润，外周血中白细胞有质和量的异常，红细胞和血小板数减少，导致贫血、出血、感染和浸润等征象的一种疾病。近年来，随着流式细胞术的发展，通过流式细胞术来分析白血病细胞的来源以及分化阶段，从而为白血病的诊断、治疗及预后及复发风险的判断提供了重要的参考信息。流式细胞术具有灵敏度高，可重复性好，一次能检测信息量大等特性，能准确地反映白血病的起源和生物学特性。
白血病免疫分型是利用荧光素标记的单克隆抗体作为分子探针，对骨髓和外周血中造血干细胞及其增殖分化、成熟过程中抗原的表达进行大量研究，多参数分析白血病细胞的细胞膜、细胞浆和细胞核的免疫表型，由此检测白血病细胞所属细胞系列和及分化程度。免疫分型使白血病的诊断更加客观、准确、可靠，对白血病的治疗及预后分析具有重要意义。, 百拇医药(林祥伟 张苏伟)