Roxby D J, Pfeiffer M B, Morley A A, Kirkland M A
Hematology Department, Flinders Medical Centre, Bedford Park, Australia.
Transfusion. 1992 Nov-Dec;32(9):834-8. doi: 10.1046/j.1537-2995.1992.32993110755.x.
Expression of the normally cryptic blood group antigen Tn has occasionally been reported in hematologic disease, but the true frequency of this change is not known. A mouse monoclonal antibody (FBT3) and immunohistochemistry were used to examine expression of the Tn antigen. Expression was not detected in 35 normal bone marrow aspirates examined, but it was detected in 5 of 725 abnormal bone marrow aspirates, including 2 (3.6%) of 55 cases of de novo acute nonlymphocytic leukemia and 2 cases that terminated in acute nonlymphocytic leukemia. In two patients, one with acute myeloblastic leukemia and the other in blast transformation of chronic myeloid leukemia, the Tn antigen was expressed on 2 percent of blast cells. In one case of non-Hodgkin's lymphoma, 4 percent of normal myeloid cells expressed the antigen. In the other two cases, one of acute myelomonocytic leukemia and the other of myelodysplasia, only 2 to 8 percent of myeloid and erythroid cells initially were Tn positive. Subsequent serial immunohistochemical studies of bone marrow aspirates and peripheral blood in these two cases showed increasing numbers of Tn-positive erythroid and myeloid cells 8 to 12 months before polyagglutination was detected serologically. Tn-positive cells increased to > 90 percent in the terminal phase in both cases of both diseases. The results suggest that Tn expression in these two patients may have conferred a growth advantage to the cells and could be related to disease progression.
正常情况下隐匿的血型抗原Tn的表达偶尔在血液系统疾病中被报道，但这种变化的真实发生率尚不清楚。使用一种小鼠单克隆抗体（FBT3）和免疫组织化学方法检测Tn抗原的表达。在所检测的35份正常骨髓穿刺物中未检测到表达，但在725份异常骨髓穿刺物中的5份中检测到，其中包括55例初发急性非淋巴细胞白血病中的2例（3.6%）以及最终发展为急性非淋巴细胞白血病的2例。在两名患者中，一名患有急性髓细胞白血病，另一名处于慢性髓细胞白血病急变期，2%的原始细胞表达Tn抗原。在一例非霍奇金淋巴瘤中，4%的正常髓细胞表达该抗原。在另外两例中，一例为急性粒单核细胞白血病，另一例为骨髓发育异常，最初只有2%至8%的髓细胞和红细胞为Tn阳性。随后对这两例患者的骨髓穿刺物和外周血进行系列免疫组织化学研究显示，在血清学检测到多凝集之前8至12个月，Tn阳性的红细胞和髓细胞数量不断增加。在这两种疾病的两例患者的终末期，Tn阳性细胞均增至>90%。结果表明，这两名患者中Tn的表达可能赋予细胞生长优势，并可能与疾病进展有关。
