CAJ | 학술논문

目的：准确地进行儿童急性白血病（AL）的诊断分型，提高初诊患儿的诊断符合率。方法：采用形态学、免疫学和细胞遗传学（MIC）相结合的诊断方法，分析了110例初诊为AL的患儿。结果：形态学与MIC分型诊断符合率为88.2%；急性淋巴细胞性白血病（ALL）免疫分型诊断符合率为92.2%；而急性髓细胞性白血病（AML）仅为62.9%。8/35例AML表达淋系抗原（1y+-AML），12/59例ALL表达髓系抗原（My+-AML）；11/110例为杂合性白血病。染色体核型异常检出率为63.6%。t（8；21）易位见于（13/21例）M2；t（7；11）易位见于1例M2；t（15；17）易位见于（2/5例）M3；t（9；22）和t（4；11）易位见于（8/64例）ALL。结论：运用MIC诊断分型方法能提高儿童AL的诊断率，为AL个体化治疗和评估预后提供信息。
목적：준학지진행인동급성백혈병（AL）적진단분형，제고초진환인적진단부합솔。방법：채용형태학、면역학화세포유전학（MIC）상결합적진단방법，분석료110례초진위AL적환인。결과：형태학여MIC분형진단부합솔위88.2%；급성림파세포성백혈병（ALL）면역분형진단부합솔위92.2%；이급성수세포성백혈병（AML）부위62.9%。8/35례AML표체림계항원（1y+-AML），12/59례ALL표체수계항원（My+-AML）；11/110례위잡합성백혈병。염색체핵형이상검출솔위63.6%。t（8；21）역위견우（13/21례）M2；t（7；11）역위견우1례M2；t（15；17）역위견우（2/5례）M3；t（9；22）화t（4；11）역위견우（8/64례）ALL。결론：운용MIC진단분형방법능제고인동AL적진단솔，위AL개체화치료화평고예후제공신식。
Objective:To establish more acurate criteria for diagnosis ofacute leukemia(AL) with children.Method:One hundred and ten cases diagnosed initialy as AL were analyzed with morphology、immunology and cytogenetics(MIC).Result:The conformity rate of cytomorphologic classification with MIC classification was 88.2%. For ALL, the conformity rate of immunologic classification with MIC classification was 92.2%, but it was only 62.9% for AML. Of the 59 ALL, 12 expressed myeloid lineage-associated antigens and 7 0f 35 AML expressed lymphoid lineage-associated antigens. Eleven cases were diagnosed as hybrid acute leukemia according to Catovsky criterion. 63.6% of the patients in this group showed abnormality in cytogenetics. Typical t(8;21)or its varicants was found in 13/21 cases of M2; t(7;11)in one case of M2;t(15;17)in 2/5 cases of M3; t(9;22) and t(4;11)in 8/64 cases of ALL.Conclusion:It is showed that MIC classification is more helpful for diagnosis of AL, and provided an experimental evidence for personalized treatment and evaluated prognosis with AL.