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目的探讨伴髓系抗原(My)表达的急性淋巴细胞白血病(My~+ALL)MIC 分型特征。方法按常规骨髓涂片及过氧化物酶染色法对120例初治 ALL 患者进行形态学分型,采用流式细胞术检测白血病细胞免疫学类型,用 R 显带技术分析染色体核型,对 My~+ALL 及 My~-ALL 患者 MIC 分型进行分析比较。结果 120例初治 ALL 患者中 My~+ALL 66例(55%),其中 My~+B-ALL 50例,占 B～ALL 的56.8%;My~+T-ALL 14例,占 T-ALL 的50%;My~+T、B-ALL 2例,占 T、B-ALL 的50%。66例My~+ALL 患者形态学分型有10例(15.1%)误诊为急性非淋巴细胞白血病(ANLL);54例 My~-ALL 无一例误诊为 ANLL。My~+ALL 患者形态学分型与免疫分型不符率或形态学分型不明确病例明显高于My~-ALL(P<0.01)。My~+ALL 患者95.5%表达 CD13,81.8%表达 CD33,77.3%同时表达 CD13及CD33,1.5%表达 CO117。CD14、CD15及 MPO 表达阴性。My~+ALL 患者 CD34阳性表达率明显高于My~-ALL(P<0.01)。My~+ALL 及 My~-ALL 患者异常染色体核型的检出率分别为72.3%和66.7%(P>0.05),My~+B-ALL 患者的 t(9;22)或 t(9;22)伴其他染色体核型异常的检出率显著高于 My~-B-ALL(P<0.01)。My~+T-ALL 及 My~-T-ALL 患者末见 t(9;22)异常。My~+ALL 和 My~-ALL 患者 CR 率分别为83.9%和79.0%,差异无统计学意义(P>0.05)。结论 My~+ALL MIC 分型部分细胞形态学可显示有髓系细胞特征,易被误诊为急性髓系白血病。My~+ALL 患者 CD34表达率明显高于 My~-ALL。My~+B-ALL 的 t(9;22)异常显著高于 My~-B-ALL。My~+ALL 与 My~-ALL 缓解率差异无统计学意义。
Objective To investigate the MIC typing characteristics of My ~ + ALL with myeloid antigen (My) expression. Methods According to the routine bone marrow smear and peroxidase staining method, 120 cases of newly diagnosed ALL patients were screened for morphological type. The type of leukemia cell immunology was detected by flow cytometry. Chromosome karyotype was analyzed by R - + ALL and My ~ -ALL patients with MIC typing analysis and comparison. Results My ~ + ALL patients were 66 (55%) in 120 cases of newly diagnosed ALL patients, of which 50 cases were My ~ + B-ALL, accounting for 56.8% of ALL; 14 cases of My ~ + T- Of 50%; My ~ + T, B-ALL 2 cases, accounting for T, B-ALL of 50%. Sixty-six My ~ + ALL patients were misdiagnosed as acute non-lymphocytic leukemia (ANLL) in 10 cases (15.1%). All 54 My-ALL patients were misdiagnosed as ANLL. My ~ + ALL patients morphological and immunotyping incompatible or morphological typing is not clear cases were significantly higher than My ~ -ALL (P <0.01). In My ~ + ALL patients, 95.5% expressed CD13, 81.8% expressed CD33, 77.3% expressed both CD13 and CD33, and 1.5% expressed CO117. CD14, CD15 and MPO negative expression. The positive rate of CD34 in My ~ + ALL patients was significantly higher than that in My ~ -ALL (P <0.01). The detection rates of abnormal chromosome karyotypes in patients with My ~ + ALL and My ~ -ALL were 72.3% and 66.7%, respectively (P> 0.05), t (9; 22) or t 22) with the detection rate of other karyotype abnormalities was significantly higher than that of My ~ -B-ALL (P <0.01). My ~ + T-ALL and My ~ -T-ALL patients with t (9; 22) abnormalities. The CR rates of My ~ + ALL and My ~ -ALL patients were 83.9% and 79.0%, respectively, with no significant difference (P> 0.05). Conclusion My ~ + ALL MIC typing part of the cell morphology can show the characteristics of myeloid cells, easily misdiagnosed as acute myeloid leukemia. The expression of CD34 in My ~ + ALL patients was significantly higher than that in My ~ -ALL. The abnormality of t (9; 22) of My ~ + B-ALL was significantly higher than that of My ~ -B-ALL. My ~ + ALL and My ~ -ALL remission rate difference was not statistically significant.