摘要
目的:研究不同年龄段急性B淋巴细胞白血病(B cell acute lymphoblastic leukemia,B-ALL)的免疫表型特点,探讨其在预测疾病预后及指导临床个体化治疗的应用。方法:应用CD45/SSC设门的四色流式细胞术对329例不同年龄段急性B淋巴细胞白血病进行免疫分型。结果:在所有被检测的病例中,表达率最高的淋系抗原为CD19、HLA-DR、CyCD79a和cTdT,其次为CD10、CD22、CD34、CD38、CD20和CyIg;髓系抗原CD13和CD33常伴随表达,CD11b、CD15、CD117与T系抗原CD4、CD7和CD56很少表达。CD10阴性早B-前体-ALL(Pro-BALL)在婴儿中发病率高,达60%;伴有CD117高表达的发病率达40%。Pro-B-ALL在其他儿童及青少年中较少见,但是随着年龄的增长,发病率又增加,青年和中老年发病率分别为22.7%和14.8%,明显高于儿童组(4.4%)。成人B-ALL免疫表型特点受年龄的影响较小,不同年龄段成人B-ALL的抗原表达异质性较小。成人BALL与儿童B-CLL相比,其CD10和CD38表达下降,CD34、CD13和CD33表达上升,存在多种具有不良预后意义的抗原异常表达。前B-ALL(Pre-B-ALL)在各年龄组发病率的差异无统计学意义(P>0.05),但随着年龄的增长,其发病率有增高的趋势,且CD20表达相对于早B-前体-ALL与普通-B-ALL明显上升。结论:不同年龄段急性B淋巴细胞白血病存在有特征性免疫表型特点,这些特点有助于预测疾病预后及指导临床个体化治疗。
Objective : To investigate the immunophenotypes of B cell acute lymphoblastic leukemia( B-ALL) in patients at different age and to explore its clinical application in prognosis prediction and individualized treatment.Method: The immunophenotyping in 329 patients with B-ALL at different ages was performed by CD45 /SSC gate fourcolor fluorescence flow cytometry. Results: In all patients detected the highest incidence of lymphoid-associated antigens was CD19,HLA-DR,CyCD79 a and cTdT,followed by CD10,CD22,CD34,CD38,CD20 and CyIg. B-ALL showed a higher concomitant expression rate of myeloid antigens CD13 and CD33; the CD11 b,CD15,CD117 and T antigens( CD4,CD7 and CD56) were rarely expressed. CD10- pro- B acute lymphoblastic leukemia( Pro- B-ALL)was predo-minant in infantile group( 60%) with CD117 higher expression( 40%). Subtype Pro- B-ALL was rarely expressed in childhood and adolescent group,but the incidence of disease increased as the age increase,the incidence of youth group( 22. 7%) and middle-aged' group( 14. 8%) were significantly higher than childhood group( 4. 4%). The influence of age on immunophenotypic characteristics of the adult B-ALL was not significant,the heterogeneity of antigen expression was less in the adult patients at different ages. The expression of CD10 and CD38 was lower,while expression of CD34,CD13 and CD33 were higher in adult patients than those in children patients. There was no significant difference in incidence of precursor- B-ALL( Pre- B-ALL) among different age groups( P > 0. 05),but its incidence increased along with age increasing,and the expression of CD20 was higher in Pre- B-ALL than that in Pro- B-ALL and common B-ALL. Conclusion: The immunophenotype characteristics of B-ALL in the patients at different ages is of great value in prediction for disease prognosis and guidence of individualized treatment.
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2015年第5期1225-1230,共6页
Journal of Experimental Hematology
关键词
急性B淋巴细胞白血病
免疫分型
四色流式细胞术
B cell acute lymphoblastic leukemia(B-ALL)
immunophenotype
four color fluorescence flow cytometry
