末端脱氧核苷酸转移酶在白血病和恶性淋巴瘤诊断中的应用

Terminal deoxynucleotidyl transferase in the diagnosis of leukemia and malignant lymphoma.

作者信息

Kung P C, Long J C, McCaffrey R P, Ratliff R L, Harrison T A, Baltimore D

出版信息

Am J Med. 1978 May;64(5):788-94. doi: 10.1016/0002-9343(78)90518-1.

Abstract

Neoplastic cells from 253 patients with leukemia and 46 patients with malignant lymphoma were studied for the presence of terminal deoxynucleotidyl transferase (TdT) by biochemical and fluorescent antibody technics. TdT was detected in circulating blast cells from 73 of 77 patients with acute lymphoblastic leukemia, 24 of 72 patients with chronic myelogenous leukemia examined during the blastic phase of the disorder and in cell suspensions of lymph nodes from nine of nine patients with diffuse lymphoblastic lymphoma. Blast cells from six of 10 patients with acute undifferentiated leukemia were TdT positive, but the enzyme was found in only two of 55 patients with acute myeloblastic leukemia. TdT was not detected in other lymphocytic or granulocytic leukemias or in other types of malignant lymphomas. The fluorescent antibody assay for TdT permits rapid and specific identification of the enzyme in single cells. The TdT assay is clinically useful in confirming the diagnosis of acute lymphoblastic leukemia, evaluating patients with blastic chronic myelogenous leukemia, and distinguishing patients with lymphoblastic lymphoma, whose natural history includes rapid extranodal dissemination, from patients with other poorly differentiated malignant lymphomas.

摘要

采用生化技术和荧光抗体技术，对253例白血病患者及46例恶性淋巴瘤患者的肿瘤细胞进行末端脱氧核苷酸转移酶（TdT）检测。在77例急性淋巴细胞白血病患者中的73例循环原始细胞、72例慢性粒细胞白血病患者处于疾病原始期时检测的24例、9例弥漫性淋巴细胞淋巴瘤患者淋巴结细胞悬液中均检测到TdT。10例急性未分化白血病患者中的6例原始细胞TdT呈阳性，但55例急性髓细胞白血病患者中仅2例检测到该酶。在其他淋巴细胞性或粒细胞性白血病以及其他类型的恶性淋巴瘤中未检测到TdT。TdT荧光抗体检测可对单细胞中的该酶进行快速、特异性鉴定。TdT检测在确诊急性淋巴细胞白血病、评估慢性粒细胞白血病原始期患者以及鉴别淋巴细胞淋巴瘤患者（其自然病程包括快速结外播散）与其他低分化恶性淋巴瘤患者方面具有临床应用价值。