Liu Yin, Chen Yuan-Ting, Li Jun-Xun, Zhang Shi-Hong
Department of Medical Laboratorial Examination, Sun-Yat-Sen University, Guangzhou, Guangdong Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2012 Aug;20(4):806-11.
This study was purpose to investigate the immunophenotype of leukemia promyelocytes (LP) and its significance through retrospective analysis of LP immunophenotype and data in new diagnosis of patients with acute promyelocytic leukemia (APL). The immunophenotype of leukemia cells in 71 APL patients was analyzed by means of 6 color immunotyping. The results indicated that MPO, CD33 and CD13 were consistently expressed in leukemia cells of all APL cases with highest average percentages (> 88%) of positive cells among all studied markers. CD117 was found to be positive in 50.7%, and its average percentage of positive cells was 52.5%. Leukemia cells in about 10% cases expressed CD15 weakly, and its average percentage of positive cells was 42.5%. CD34 and HLA-DR showed decreased expressions in a small number of cases and were negative in the others. CD2 and CD56 were weakly expressed in nearly 25% APL cases, and the average percentage of positive cells were 39.3% and 42.3%, respectively. Thereby, it is of the opinion that the typical immunophenotype is characterized by MPO(+)CD13(+)CD33(+)CD117(±)CD15(±)CD34(-)HLA-DR(-) in APL. CD2 and CD56 were expressed significantly higher in CD34(+) or HLA-DR(+) group (including CD34(+) HLA-DR(+), CD34(+) HLA-DR(-) and CD34(-)HLA-DR(+)) than in CD34(-) and HLA-DR(-) group. Significant differences were also found in WBC and platelet counts, percentage of peripheral blood leukemic promyelocytes and the expression of CD13 among CD15 < 10%, 10% < CD15 < 20% and CD15 > 20% groups. It is concluded that the APL has a characteristic immunophenotypic profile, flow cytometric immunophenotyping may be considered as a useful tool for rapid recognition of APL and also may be considered to have an important significance for analysing origin of leukemic cells and clinical outcome of patients.
本研究旨在通过回顾性分析急性早幼粒细胞白血病(APL)初诊患者的白血病早幼粒细胞(LP)免疫表型及相关数据,探讨LP的免疫表型及其意义。采用六色免疫分型法分析71例APL患者白血病细胞的免疫表型。结果显示,所有APL病例的白血病细胞均持续表达MPO、CD33和CD13,在所有研究标志物中阳性细胞平均百分比最高(>88%)。发现CD117阳性率为50.7%,其阳性细胞平均百分比为52.5%。约10%病例的白血病细胞弱表达CD15,其阳性细胞平均百分比为42.5%。少数病例中CD34和HLA-DR表达降低,其他病例为阴性。近25%的APL病例中CD2和CD56弱表达,阳性细胞平均百分比分别为39.3%和42.3%。因此,认为APL典型的免疫表型特征为MPO(+)CD13(+)CD33(+)CD117(±)CD15(±)CD34(-)HLA-DR(-)。CD2和CD56在CD34(+)或HLA-DR(+)组(包括CD34(+) HLA-DR(+)、CD34(+) HLA-DR(-)和CD34(-)HLA-DR(+))中的表达明显高于CD34(-)和HLA-DR(-)组。CD15<10%、10%<CD15<20%和CD15>20%组在白细胞和血小板计数、外周血白血病早幼粒细胞百分比及CD13表达方面也存在显著差异。结论是,APL具有特征性的免疫表型谱,流式细胞术免疫分型可被视为快速识别APL的有用工具,也可能对分析白血病细胞起源及患者临床结局具有重要意义。