交叉抗原表达的急性白血病的临床生物学特征分析

【】　目的　分析交叉抗原表达的急性白血病的临床特征及缓解率。　方法　对2009年10月-2010年11月血液内科的210例交叉表达髓系和淋巴细胞系相关抗原的初治急性白血病患者的标本，采用流式细胞术检测白血病细胞的免疫表型，根据免疫标记和FAB（French、American、Britain）分型进行分组，分析其异质性的生物学特征和影响缓解率的相关因素。　结果　210例急性白血病的FAB分型以AML-M1/M2（82例）和ALL（78例）为主；免疫分型以B淋巴细胞系和髓系混合表达多见（116例），其中CD34表达率高达91.4%（192例），CD7表达率为50.5%（106例），且与CD34相关（P=0.04）；出现CD34、CD7、CD19三者共表达的患者缓解率较低（9.09%）。　结论　交叉抗原表达的急性白血病的诊断有赖于免疫分型的判断，其分化抗原的表达类型是影响其缓解率的重要因素。【Abstract】　Objective　Toobservetheclinicalcharactersofacuteleukemiawithcross-lineageantigenexpressionandanalyzetheremissionrate.　Methods　BetweenOctober2009andNovember2010,210patientswerediagnosedandclassifiedbymorphology.Cytochemistryandimmunologywereusedtoanalyzetheimmunophenotype.AccordingtotheimmunostainingrelativefactorsandFAB(French,American,andBritain)phenotypestandard,thesamplesweredividedintoseveralgroups.Theconicalcharactersandrelativefactorsofremissionratewereanalyzed.　Results　In210patientswithcross-lineageantigenexpression,AL,AML-M1/M2(82cases)andALL(78cases)werecommoninFABphenotype,andcross-lineageofBlineageandmyelolineagewerecommoninimmunotype(116cases).CD34gotthehighestexpressionfrequencyofall(192cases),andhadthemostimportanteffectonpatients′prognosis.CD7wasalsopositivecommonly(106cases)andrelatedwithCD34(P=0.04).Soit′ssignificantfortheoutcome.Thepatientswhogotco-expressionofCD34,CD7andCD19hadworseprognoses.　Conclusions　Acuteleukemiawithcross-lineageantigenexpressionisaspecialtypeandisconfirmedbyimmunotype.Furthermore,expressiontypesofdifferentiationantigenarecriticalfortheprognosis.