中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (10): 1777-1782.doi: 10.3969/j.issn.1673-8225.2011.10.015

• 干细胞转基因表达 transgenic expression in stem cells • 上一篇    下一篇

急性髓细胞性白血病M2患者形态学及免疫学分型与融合基因染色体检查的价值

易丽萍，郭新红   

  1. 天津市海河医院血液、血透科，天津市  300350
  • 收稿日期:2010-10-20 修回日期:2011-01-23 出版日期:2011-03-05 发布日期:2011-03-05
  • 作者简介:易丽萍★，女，1973年生，湖南省双峰县人，汉族，2009年毕业，硕士，主治医师，主要从事超声白血病，肾病的研究。 qiunanhai@126.com

The value of morphology and immunological classification and fusion gene chromosome examination in acute leukemia M2 patients

Yi Li-ping, Guo Xin-hong   

  1. Department of Hematology and Hemodialysis, Tianjin Haihe Hospital, Tianjin  300350, China
  • Received:2010-10-20 Revised:2011-01-23 Online:2011-03-05 Published:2011-03-05
  • About author:Yi Li-ping★, Master, Attending physician, Department of Hematology and Hemodialysis, Tianjin Haihe Hospital, Tianjin 300350, China qiunanhai@126.com

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465

被引次数

13

摘要：

背景：传统的形态学分型法仅能使70%左右的急性白血病得以准确分型，单纯的FAB分型已远远不能满足临床需要。
目的：评价形态学、免疫分型、融合基因、染色体检查在急性髓细胞性白血病(M2)中的诊断价值及预后意义。
方法：选择新疆医科大学第一附属医院收治的急性髓细胞性白血病患者M2型76例，男40例，女36例。用反转录-聚合酶链反应技术检测AML1/ETO融合基因的表达、R带法进行染色体核型分析、流式细胞仪免疫分型检测，应用形态学和免疫分型、融合基因、染色体检查，并持续观察，定期检查血象等相关检查，由是否能明确诊断或协助诊断，对复发有无相关检查预测性来分析其诊断价值及预后影响因素。
结果与结论：76例患者中有形态学不易分类的6例患者，结合免疫分型、融合基因及染色体检查可明确，单纯髓系抗原表达较伴有干祖系抗原表达缓解率高，CD19抗原可与部分急性髓系白血病有交叉表达，且有交叉表达的有较好的预后，伴有CD7抗原表达7例均完全缓解，可能更倾向于分化成熟的细胞，具有单纯t(8，21)、融合基因阳性者预后较佳，完全缓解率高。提示形态学、免疫学分型结合融合基因、染色体检查可提高急性白血病M2的诊断准确性、判断预后。

关键词: 急性髓细胞性白血病M2, 形态学, 免疫分型, 融合基因, 染色体

Abstract:

BACKGROUND: Only about 70% of acute leukemia can be classified correctly by traditional morphological classification, simple FAB classification has not met the clinical requirements.
OBJECTIVE: To evaluate the diagnostic value and prognostic significance of morphology, immunological classification, fusion gene, chromosome in acute leukemia M2 (AML-M2) patients.
METHODS: A total of 76 AML-M2 patients, comprising 40 males and 36 females, who were received treatment, were enrolled from First Affiliated Hospital of Xijiang Medical University. The expression of AML1/ETO fusion gene was detected by reverse transcription-polymerase chain reaction (RT-PCR) technology, karyotype analysis and flow cytometry immunological classification were detected by R-band method, morphology, immunological classification, fusion gene, chromosome were used to examine, continuously observe, and periodically inspect hemogram and other felated inspection. The diagnostic value and prognostical factors were analyzed by the prediction of clear diagnosis or coefficient diagnosis, recurrence with or without the relevant checks.
RESULTS AND CONCLUSION: Six patients in 76 cases were not easily classified by morphology. Morphology combined with immunological classification, fusion gene, chromosome can be examined definitely. The myeloid antigen expression has higher remission rate than the stem-ancestor antigen expression. There are across expression by CD19 antigen expression and some acute leukemia antigen expression which has a good prognosing. Seven cases with CD7 antigen expression were completely relieved, and may be more inclined to differentiate into mature cells. The cases which have pure t (8, 21), positive fusion gene have a better prognosis and higher remission rate. The combination of morphology, immunological classification, fusion gene and chromosome can increase diagnosis accuracy and predicting prognosis of AML M2 patients.

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