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为了探讨急性早幼粒细胞白血病(APL)免疫表型特征,以CD45/SSC设门,对143例APL进行多参数流式细胞术免疫分型,比较初发和复发时免疫表型变化。随机选择同期42例HLA-DR阴性的非APL的急性髓系白血病(AML)患者作为对照,其中31例CD34也为阴性,探讨其与初发APL的免疫表型的差异。结果表明:①初发APL中91.9%表现为CD34和HLA-DR共阴性,复发时CD34和HLA-DR阳性率增高(37.5%vs3.0%,37.5%vs3.9%)。初发APL组CD34阳性率低于DR-AML组(3.0%vs23.4%),初发APL组CD34即使阳性,其表达水平也较低(p<0.05)。②初发APL组CD33阳性率高于各对照组(97.0%vs75.0%,83.3%,83.9%),其表达水平亦高于各对照组(p<0.05)。③初发APL组淋系抗原中仅见CD2的表达,未见CD7的表达,而DR-AML组、CD34-/DR-AML组CD7阳性率分别为12.0%,6.5%,高于初发APL组(p<0.05)。结论:免疫表型检测可以为APL的快速诊断提供依据,对HLA-DR-的AML可以从CD34的表达与否、CD33的表达水平、淋系抗原表达情况以及SSC特征等方面与APL进行鉴别。
In order to investigate the immunophenotypic characteristics of acute promyelocytic leukemia (APL), 143 APL patients were immunophenotyped by CD45 / SSC. Immunophenotypic changes were compared between initial and recurrent APL. Twenty-four patients with HLA-DR-negative non-APL acute myeloid leukemia (AML) were randomly selected as controls. Twenty-one of these patients were also negative for CD34 immunophenotype. The results showed that: (1) 91.9% of newly diagnosed APL showed a negative expression of CD34 and HLA-DR, and the positive rates of CD34 and HLA-DR were higher in recurrence (37.5% vs 3.0%, 37.5% vs 3.9%). The positive rate of CD34 in the newly diagnosed APL group was lower than that in the DR-AML group (3.0% vs 23.4%). The positive expression of CD34 in the newly diagnosed APL group was also lower (p <0.05). ② The positive rate of CD33 in the newly diagnosed APL group was higher than that in the control group (97.0% vs 75.0%, 83.3%, 83.9%), and the expression level of CD33 was also higher than that of the control group (p <0.05). ③ The expression of CD2 was only found in the lymphocytes of APL patients, but no positive expression of CD7 was found in these patients. The positive rates of CD7 in DR-AML group and CD34- / DR-AML group were 12.0% and 6.5% (p <0.05). Conclusion: Immunophenotyping can provide a basis for rapid diagnosis of APL. HLA-DR-AML can be differentiated from APL in terms of CD34 expression, CD33 expression, lymphoid antigen expression and SSC characteristics.