Tavassoli M, Shaklai M, Crosby W H
Am J Clin Pathol. 1979 Jul;72(1):59-62. doi: 10.1093/ajcp/72.1.59.
Blood and bone-marrow smears from adult patients with acute leukemias were stained for esterase reaction, consecutively with naphthol AS D-chloracetate (chloracetate esterase) followed by alpha naphthyl butyrate (nonspecific esterase). The two substrates were, respectively, granulocyte- and monocyte-specific. By this method three subgroups of acute nonlymphocytic leukemias could be distinguished. Leukemic cells may be positive for either chloracetate esterase or nonspecific esterases, and the authors believe these two subgroups represent "true" granulocytic and "pure" monocytic leukemias. In a third group, leukemic cells contained both esterases in the same cell, and it is believed this group may represent "true" myelomonocytic leukemias. In the majority of patients in this group, leukemia evolved from a preleukemic phase. When only Romanowsky-stained smears are used, the monocytoid feature and absolute elevated monocyte counts in acute granulocytic leukemia may lead to an erroneous diagnosis of the leukemia as acute myelomonocytic leukemia. This happened in five of the 13 cases in the study. The presence of granulocyte- and monocyte-specific esterases in a single cell supports the concept of a common origin of granulocytes and monocytes. The authors conclude that the combined esterase reaction can distinguish among acute granulocytic leukemia, acute monocytic leukemia, and acute myelomonocytic leukemia.
对成年急性白血病患者的血液和骨髓涂片进行酯酶反应染色，先连续使用萘酚AS D - 氯乙酸酯（氯乙酸酯酶），再使用α萘丁酸酯（非特异性酯酶）。这两种底物分别对粒细胞和单核细胞具有特异性。通过这种方法，可以区分急性非淋巴细胞白血病的三个亚组。白血病细胞可能对氯乙酸酯酶或非特异性酯酶呈阳性，作者认为这两个亚组分别代表“真性”粒细胞白血病和“纯”单核细胞白血病。在第三组中，白血病细胞在同一细胞内同时含有这两种酯酶，据信该组可能代表“真性”粒单核细胞白血病。在该组的大多数患者中，白血病是从前白血病阶段发展而来的。当仅使用罗曼诺夫斯基染色涂片时，急性粒细胞白血病中的单核细胞样特征和单核细胞绝对计数升高可能导致将白血病错误诊断为急性粒单核细胞白血病。本研究的13例病例中有5例出现这种情况。单个细胞中存在粒细胞和单核细胞特异性酯酶支持了粒细胞和单核细胞有共同起源的概念。作者得出结论，联合酯酶反应可以区分急性粒细胞白血病、急性单核细胞白血病和急性粒单核细胞白血病。
