Chen Fang, Hu Yan-Ping, Wang Xiao-Hui, Fu Shuang, Fu Yu, Liu Xuan, Zhang Min-Yu, Wang Shao-Kun, Zhang Ji-Hong
Laboratory of Hematology, Shengjing Hospital of China Medical University, Shenyang 110022, Liaoning Province, China.
Laboratory of Hematology, Shengjing Hospital of China Medical University, Shenyang 110022, Liaoning Province, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2016 Apr;24(2):321-5. doi: 10.7534/j.issn.1009-2137.2016.02.003.
To investigate the immunophenotype of leukemia promyelocytes (LP) in bone marrow of patients with acute promyelocytic leukemia (APL) and to explore their characteristics and significance.
The immunophenotypes of leukemia cells in 43 patients with APL were analyzed by means of 4 color immunophenotypes; the cell population in which CD45 strength localized at 10(2) and the SSC strength locatized at 10(2) was defined as R3, the cell population in which CD45 strength localized at 10(3) and the SSC strength localized at 10(2) was defined as R5, moreover the ratio of positive cells >80% was defined as strong positive expression, the ratio of positive cells between 20%-80% was difined as weak positive expression, the ratio of positive cells <20% was difined as negative by gating method of CD45/SSC.
There was a abnormal cell population (R3) in 79.07% cases; the immunophenotypes of R3 was cheracteried by high SSC, weaker expression of CD45, the rate of CD38, CD9 and CD13 all was 100%, moreover their bright expression (>80%) was 86.05%, 90.70% and 86.05%, respectively; the positive expression rate of CD33, CD117 and CD64 was 97.67%, 95.35% and 83.80% respectively, moreover thier bright expression was 84.04%, 69.77% and 30.23% respectively; the CD15 was weakly expressed in 39.53% cases, the CD34 and HLA-DR were weakly expression in 16.28% and 6.98% cases respectively. All the cases did not express CD116. There were 2 cell populations (R3 and R5) in 20.93% cases, the immunophenotypic features of R3 were cosistant with above mentioning, while the immunophenotypes of R5 were lower than those of R3 SSC; the fluorescence intensity of CD45 was higher, but lower than that in normal lymphycytes, the positive rate of CD9, CD13, MPO was 100%, moreover thier fluorescence intensity was high; they did not expressed CD123, CD25, CD22, CD4, CD64 and CD14. Thereby it can be concluded that the typical immunophenotypes is characterized by CD13(+) CD9(+) CD38(+) CD33(+) CD117(+) CD64(+) CD11b(-) CD34(-) HLA-DR(-) in APL. There was a special immunophenotype in the APL with basophilic granules. Conclusoin: APL has a characteristic immunophenotypic profile, whose typical immunophenotype is characterized by CD13(+) CD9(+) CD38(+) CD33(+) CD117(+) CD64(+) CD11b(-) CD34(-) HLA-DR(-). The special immunophenotype exists in the APL with basophilic granules. Flow cytometric immunophenotyping may be a useful for rapid recognition of APL and has significant for prognosis.
探讨急性早幼粒细胞白血病（APL）患者骨髓中白血病早幼粒细胞（LP）的免疫表型，以了解其特点及意义。
采用四色免疫表型分析43例APL患者白血病细胞的免疫表型；将CD45强度定位于10(2)且SSC强度定位于10(2)的细胞群定义为R3，将CD45强度定位于10(3)且SSC强度定位于10(2)的细胞群定义为R5，采用CD45/SSC门控法，阳性细胞比例>80%定义为强阳性表达，阳性细胞比例在20% - 80%定义为弱阳性表达，阳性细胞比例<20%定义为阴性。
79.07%的病例存在异常细胞群（R3）；R3免疫表型特点为SSC高、CD45表达较弱，CD38、CD9和CD13的阳性率均为100%，其强阳性表达（>80%）分别为86.05%、90.70%和86.05%；CD33、CD117和CD64的阳性表达率分别为97.67%、95.35%和83.80%，其强阳性表达分别为84.04%、69.77%和30.23%；39.53%的病例CD15弱阳性表达，16.28%和6.98%的病例CD34和HLA - DR弱阳性表达。所有病例均不表达CD116。20.93%的病例有两个细胞群（R3和R5），R3的免疫表型特征与上述一致，而R5的免疫表型SSC低于R3；CD45荧光强度较高，但低于正常淋巴细胞，CD9、CD13、MPO阳性率为100%，且荧光强度高；不表达CD123、CD25、CD22、CD4、CD64和CD14。由此得出APL典型免疫表型特征为CD13(+) CD9(+) CD38(+) CD33(+) CD117(+) CD64(+) CD11b(-) CD34(-) HLA - DR(-)。伴有嗜碱性颗粒的APL有特殊免疫表型。结论：APL具有特征性免疫表型谱，其典型免疫表型为CD13(+) CD9(+) CD38(+) CD33(+) CD117(+) CD64(+) CD11b(-) CD34(-) HLA - DR(-)。伴有嗜碱性颗粒的APL存在特殊免疫表型。流式细胞术免疫表型分析有助于快速识别APL，对预后有重要意义。
