CAJ | 학술논문

目的：探讨成人急性淋巴细胞白血病（ALL）免疫表型的特点和临床意义。方法应用流式细胞术检测57例初诊成人ALL患者的免疫表型，分析其临床特点和意义。结果 B细胞急性淋巴细胞白血病（B?ALL）患者中CD19、CD22表达阳性率明显高于CD10和CD20（P<0.05）。T细胞急性淋巴细胞白血病（T?ALL）中CD7和cCD3表达阳性率高。早期抗原CD34、CD38在各种分型ALL中均高表达。HLA?DR仅在B?ALL中呈较高的阳性表达率。My+?ALL和My-?ALL患者比较，基本资料、完全缓解率和复发率均无统计学差异（P>0.05），但My+?ALL患者早期抗原CD34和HLA?DR抗原阳性表达率明显高于My-?ALL患者（P<0.05）。细胞遗传学分析提示，核型异常组患者复发率高。高危核型组患者较标危核型组CD20和CD13表达强（P<0.05）。结论成人ALL患者免疫分型及染色体核型有着明显的异质化特点，染色体核型异常患者复发率高，可以为临床医生对ALL进行分层诊断和个体化治疗提供依据。
목적：탐토성인급성림파세포백혈병（ALL）면역표형적특점화림상의의。방법응용류식세포술검측57례초진성인ALL환자적면역표형，분석기림상특점화의의。결과 B세포급성림파세포백혈병（B?ALL）환자중CD19、CD22표체양성솔명현고우CD10화CD20（P<0.05）。T세포급성림파세포백혈병（T?ALL）중CD7화cCD3표체양성솔고。조기항원CD34、CD38재각충분형ALL중균고표체。HLA?DR부재B?ALL중정교고적양성표체솔。My+?ALL화My-?ALL환자비교，기본자료、완전완해솔화복발솔균무통계학차이（P>0.05），단My+?ALL환자조기항원CD34화HLA?DR항원양성표체솔명현고우My-?ALL환자（P<0.05）。세포유전학분석제시，핵형이상조환자복발솔고。고위핵형조환자교표위핵형조CD20화CD13표체강（P<0.05）。결론성인ALL환자면역분형급염색체핵형유착명현적이질화특점，염색체핵형이상환자복발솔고，가이위림상의생대ALL진행분층진단화개체화치료제공의거。
Objective To study the immunophenotype and chromosome karyotype of 57 adult patients with newly?diagnostic acute lymphoblastic leukemia(ALL). Methods The immunophenotype and chromosome karyotype of 57 adult patients with newly?diagnostic ALL were determined by using flow cytometer and karyotyping,and then the clinical characteristics and significance were analyzed. Results In patients with B cell acute lymphoblastic leukemia(B?ALL),the expression of CD19 and CD22 were significantly higher than CD10 and CD20(P<0.05). The expression of CD7 and CD3 were much higher in patients with T cell acute lymphoblastic leukemia(T?ALL). As for the early antigen,patients of all subtypes of ALL showed high expression rate of CD34 and CD38. In addition,the HLA?DR was only detected in B?ALL. There was no difference in comparison with clinical characteristics,total rate of CR and rate of relapse between ALL with and without myeloid antigen expression. The expression rate of CD34 and HLA?DR was higher in My+?ALL(P<0.05). The relapse rate was much higher in these patients with abnormal karyotype than other pa?tients(P<0.05). Patients with high?risk karyotype showed higher expression rates of CD20 and CD3 than those with standard?risk. Conclusion The immunophenotypes and chromosome karyotypes show obviously heterogeneous features,and the patients with abnormal karyotypes have higher relapse rate. These above mentioned methods are applicable for the diagnosis and individualized treatment of ALL patients.