摘要
目的:探讨细胞形态学(包括细胞化学)、免疫表型及二者联合分析对初诊急性髓细胞白血病(Acutemyeloid leukemia,AML)的诊断价值,以指导流式细胞术对AML的诊断工作,提高诊断分型准确率。方法:回顾性分析已确诊的113例AML患者的细胞形态学与免疫表型结果。免疫表型采用流式细胞术,用23种荧光标记单克隆抗体(McAb)测定白血病细胞的抗原表达。结果:①形态学分型与最终诊断符合率为79.4%,免疫表型分型与最终诊断符合率为85.3%,二者联合分析与最终诊断符合率为96.5%。②髓系抗原CD117、CD13、CD33可在各型中高表达,无特异性;cMPO可在除M0的各型中高表达;CD14、CD64在M4、M5中高表达;CD34及HLADR在M3中低表达;各型AML均可见淋系抗原表达,主要是CD4、CD7、CD9、CD10、CD19、CD56。结论:AML患者细胞抗原表达复杂,异质性强,多个抗原综合分析及SSC/CD45散点图上的细胞分布特征,有助于判断白血病细胞的来源、种类与阶段;流式细胞仪对白血病细胞的计数受多种因素影响,其百分比例不如形态学准确;联合应用细胞形态学与免疫表型分析,可以相互弥补,大大提高诊断与分型的准确率。
Objective：To investigate the value of morphology,immunophenotype,and combined analysis of both for primary diagnosis of acute myeloid leukemia（AML）.in order to conduct the diagnosis of AML by flow cytometry and raise the diagnostic accuracy.Methods：A retrospective study on cell morphology and immunophenotype of 113 cases of established AML was performed.Immunophenotype analysis was carried out by flow cytometry,and 23 kinds of immune fluorescence marked McAb were used to detect the antigen expression of leukemia cells.Results：The coincidence between the morphology type and the final diagnosis was79.4%,that between immunophenotype and the final diagnosis was 85.3%.When morphology type and immunophenotype were combined,the final coincidence rate was 96.5%.The expression rates of modularly system antigen CD117,CD13,and CD33 were high,but with no specificity.cMPO was expressed in almost each morphology type except M0.The expressions of CD14 and CD64 in type M4 and M5 were higher than those in other types.The expressions of CD34 and HLADR in type M3 were lower than those in other types.Lymphatic system antigen was expressed in every type of AML,mainly CD4,CD7,CD9,CD10,CD19,and CD56.Conclusion：The antigen expression in each type of AML was complicated and with high heterogeneity.Analysis with enough antigens and the scatter situation of cells in Gate SSC/CD45 would be helpful for judging the origin,type,and phase of leukemic cells. Because of many influencing factors,the counting by flow cytometry is not as exact as classification by morphology.Analysis of morphology combined with immunophenotype can improve the accuracy of diagnosis and classification.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2010年第11期1761-1764,共4页
Journal of Chongqing Medical University
作者简介
作者介绍：钟辉秀（1968-），女，副主任检验师，研究方向：各种血液病的形态学诊断及实验室检查。
