成年人伴CD2表达B系急性淋巴细胞白血病免疫表型特征分析

目的 了解成年人伴CD2表达B系急性淋巴细胞白血病(CD+2 B-ALL)的免疫表型特征,为临床诊断、治疗及预后判断提供依据.方法 应用流式细胞术及多种单克降抗体检测18例成年人CD+2B-ALL及68例CD-2 B-ALL患者的免疫表型,并对其结果进行分析比较.结果 CD+2 B-ALL的发病年龄明显小于CD-2 B-ALL,18例成年人CD+2 B-ALL的大部分表面标志物与CD-2 B-ALL相似,其中CD10表达水平[(73.78±26.67)%]高于CD-2 B-ALL[(52.84±35.25)%],差异有统计学意义(t=2.35,P<0.05),CD33表达水平[(15.46±27.41)%]则低于CD-2 B-ALL[(31.15±27.72)%],差异有统计学意义(t=2.16,P<0.05);所有B-ALL患者都高表达CD34,阳性表达率分别为72.2%(13/18)和80.9%(55/68),差异无统计学意义(χ2=0.64,P>0.05).CD+2 B-ALL的CD20阳性率明显低于CD-2 B-ALL,差异有统计学意义(χ2=11.38,P<0.05).CD+2 B-ALL伴髓系抗原(CD13或CD33)表达率为44.4%(8/18),明显低于CD-2 B-ALL的72.1%(49/68),差异有统计学意义(χ2=4.86,P<0.05).结论 成年人CD+2 B-ALL与CD-2 B-ALL具有相似的免疫表型,主要来源于造血干细胞的恶性转化,CD+2 B-ALL伴髓系抗原(CD13、CD33)及CD20表达明显低于CD2 B-ALL,提示成年人CD+2 B-ALL可能有较好的预后.

Immunophenotypic features of adult CD+2 B cell acute lymphoblastic leukemia

Objective To study the immunophenotypic feature of CD+2 adult B cell acute lymphoblastic leukemia (CD+2 B-ALL) and provide evidences for the diagnosis, therapy and prognosis. Methods The immunophenotypes of 18 cases of adult CD+2 B-ALL and 68 cases of adult CD-2 B cell acute lymphoblastic leukemia(CD-2 B-ALL) were assayed by a panel of monoclonal antibodies (McAbs) with FACS. Results The age of CD+2 B-ALL adults was younger compared to that of CD-2 B-ALL. The patients in the CD; group were similar to CD-2 group for the expression of most of the cell surface antigens assayed. However, it was notable that expression frequencies of CD10 [(73.78±26.67) %] in CD+2 B-ALL was higher than those in CD; B-ALL [(52.84±35.25) %] (t = 2.35, P<0.05) and CD33 [(15.46±27.41) %] were significantly lower than that of CD2 BALL [(31.15+27.72) %] (t = 2.16, P<0.05). Both groups showed high positive expression for CD34 72.2 % (13/ 18) and 80.9 % (55/68), respectively (χ2 = 0.64, P >0.05). The CD20 expression in CD+2 B-ALL was lower than that in CD-2 B-ALL significantly (χ2 = 11.38, P <0.05). The myeloid antigen (CD13 or CD33) expression in CD+2 B-ALL 44.4 % (8/18) was lower than that in CD-2 B-ALL 72.1 %(49/68) (χ2 = 4.86, P <0.05). Conclusion Patients in the CD+2 B-ALL were similar to CD-2 B-ALL for expression of most of the cell surface antigens assayed. CD+2 B-ALL showed low expression frequency of myeloid antigens (CD13, CD33) and CD20 antigens than CD-2 B-ALL. These results suggested that those with the CD+2 B-ALL immunophenotype generally presented with favorable prognostic features and usually could achieve good outcomes after treatment.