流式细胞仪在儿童急性B淋巴细胞性白血病免疫分型中的应用

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上传时间：2015-04-15
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流式细胞仪在儿童急性B淋巴细胞性白血病免疫分型中的应用

流式细胞仪在儿童急性Ｂ淋巴细胞性白血病免疫分型中的应用

【摘要】目的研究流式细胞仪检测儿童急性B淋巴细胞性白血病（B-ALL）免疫分型的临床价值，并探讨与预后的关系。方法利用流式细胞仪对39例B-ALL患儿在初诊时进行免疫分型。CD45-SSC设门，在CD19、CD10、CD20和CD22中选择两个单克隆抗体组合，进行三色组合分析。髓系抗体选用CD33和CD13。根据是否伴有髓系抗原表达分为两组，并随访预后。结果 ①CD19、CD22、CD10的阳性率都超过或接近90%，分别为CD19：94．87%，CD22：92．31％，CD10：87．18％，而CD20只有15．38％的阳性率；有33．33%的患儿检测到髓系抗原（My）标志，其中以CD+138例，CD+335例；②共有6例患儿复发，两组经χ2精确概率法检验，P＞0．05，差异无统计学意义。结论 ①流式细胞仪可以用于绝大多数的B-ALL患儿免疫表型的检测;②伴有髓系表达不具有提示复发的意义。

【Abstract】 Objective To investigate the value of detecting immunophenotypes by flow cytometry(FCM) in B-lineage acute lymphoblastic leukemia (B-ALL) and discuss the relationship between immunophenotype and outcome.Methods 39 children with B- ALL were enrolled at diagnosis and immunophenotypes were detected by FCM.Gating was performed using the CD45-SSC plot.Various combinations with two monoclonal antibodies among CD19,CD10,CD20 and CD22 were analyzed with three-color stainings.CD33 and CD13 were used as myeloid antibodies for B-ALL with myeloid markers.2 groups were divided by myeloid markers.Results ①The positive rates of CD19,CD22 and CD10 were 94．87%,92．31%,and 87．18% respectively.The positive rates of CD20 was only 15．38%.CD13 and CD33 were expressed in 33．33% children with B-ALL,in which 8 cases of CD13 positive and 5 cases of CD33 positive were included.②There are 6 patiens relapse.There were no significance between 2 groups by Fisher’s Exact Test( P＞0．05).Conclusion ①Flow cytometry can be used to detect immunophenotypes in the majority of children with B-ALL.②Myeloid markers in acute B-ALL are not the risk factors of relapse.

【Key words】Children；B-lineage Leukemia；Immunophenotype；Flow cytometry

白血病免疫分型是对形态学分型的重要补充和进一步深化，随着儿童急性白血病治疗的进展，其免疫分型越来越受到重视，国际白血病MIC分型协作组认为免疫分型对每一例急性白血病都是必不可少的。为了发现儿童急性B淋巴细胞白血病（B-ALL）免疫表型的特点及与预后的关系，我们利用流式细胞仪对39例急性B淋巴细胞白血病患儿的免疫表型进行分析，并对其治疗结果动态随访。现报告如下。

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