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[T 玫瑰花结与 B 玫瑰花结形成及非特异性酸性酯酶在急慢性白血病鉴别诊断中的诊断价值]

[The diagnostic value of T- and B-rosette formation and the unspecific acid esterase in the differential diagnosis of acute and chronic leukemia].

作者信息

Gudat F, Albrecht R, Kasper M, Krey G, Dürmüller U, Heitz P, Ludwig C, Christen C, Obrecht J P

出版信息

Schweiz Med Wochenschr. 1981 Sep 5;111(36):1325-30.

PMID:6946556
Abstract

The diagnostic significance of acid non-specific alpha-naphthyl-acetate (ANAE) and of rosette formation of leukemic cells with sheep and mouse erythrocytes was studied in 8 patients with acute myeloic leukemia (AML), in 4 patients with acute lymphatic leukemia (ALL) and in 14 patients with chronic lymphatic leukemia (CLL). ANAE showed typical diffuse cytoplasmic activity in all cases of AML. The enzyme activity was granular in both of the lymphoid malignancies, T-ALL and B-CLL, allowing differentiation from AML but not between B- and T-leukemia cells. Rosette formation with mouse erythrocytes (ME) was diagnostic in all 14 cases of CLL and superior to labeling of surface immunoglobulin (8 of 14 cases positive). ME-rosette forming myeloblasts were detected in 2 of 4 evaluated cases of AML. Rosette formation with sheep erythrocytes (SE), including cytological evaluation of rosette-forming cells, was diagnostic in all cases of ALL (= T-ALL). In 6 of 9 patients with AML, however, rosette formation with SE was observed in a few cells, including myeloblasts with Auer rods. The occurrence of blasts in myeloic leukemia carrying lymphoid cell markers is discussed in the light of recent findings, according to which lymphoblastoid cells may arise in the course of myeloic leukemia requiring antileukemic treatment different from that of AML.

摘要

对8例急性髓细胞白血病(AML)患者、4例急性淋巴细胞白血病(ALL)患者和14例慢性淋巴细胞白血病(CLL)患者,研究了酸性非特异性α-萘乙酸酯酶(ANAE)以及白血病细胞与绵羊和小鼠红细胞形成玫瑰花结的诊断意义。在所有AML病例中,ANAE均显示典型的弥漫性胞质活性。在两种淋巴系统恶性肿瘤即T-ALL和B-CLL中,酶活性呈颗粒状,这有助于与AML鉴别,但不能区分B淋巴细胞白血病和T淋巴细胞白血病细胞。与小鼠红细胞(ME)形成玫瑰花结在所有14例CLL中均具有诊断价值,且优于表面免疫球蛋白标记(14例中有8例阳性)。在4例评估的AML病例中有2例检测到形成ME玫瑰花结的原粒细胞。与绵羊红细胞(SE)形成玫瑰花结,包括对形成玫瑰花结细胞的细胞学评估,在所有ALL病例(即T-ALL)中均具有诊断价值。然而,在9例AML患者中的6例中,在少数细胞中观察到与SE形成玫瑰花结,包括带有奥氏小体的原粒细胞。根据最近的研究结果,讨论了具有淋巴样细胞标记的髓细胞白血病中母细胞的出现情况,据此,淋巴母细胞样细胞可能在髓细胞白血病过程中出现,需要不同于AML的抗白血病治疗。

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