【摘要】 目的　探讨急性淋巴细胞白血病 (ALL)的髓系抗原、P 糖蛋白 (P gp)和CD3 4 表达特点及其与预后的关系。方法　采用间接免疫荧光法标记流式细胞仪 (FCM )检测 84例初治ALL患者的免疫表型。结果　ALL髓系抗原阳性率为 17.8% ,其中CD13 阳性最常见。CD3 4 表达阳性率为45 .3 % ,与髓系抗原表达和治疗缓解率无显著相关性。髓系抗原阳性组病例 (My+ ALL)肝脾肿大明显 ,白细胞总数增高显著 ,完全缓解 (CR)率明显低于阴性组病例 (P <0 .0 1)。P gp阳性表达率为 3 2 .1% ,P gp表达阳性与My+ ALL化疗效果有相关性。结论　My+ ALL细胞对于常规诱导缓解方案不敏感 ,选择兼顾ALL +AML的方案可提高治疗效果。P gp高度表达与低CR率有密切关系更多还原

【Abstract】 Objective To explore the expression of myeloid markers and P-glycoprotein(P-gp)and CD 34 antigen on lymphoblasts in ALL and its relationship with prognosis.Methods Immunophenotypes were examined using indirect immunofluorescence assays by flow cytometry in 84 ALL.Results The incidence of myeloid antigen expression in ALL was 17.8% and the commonest one was CD 13.CD 34 was expressed in lymphoblasts from 38 of 84 patients(45.3%).There was no relationship between expression of CD 34 and myeloid antigen.The CR rate in My +ALL was lower than that in My -ALL(20% vs 60.9%,P<0.01),and was no relation with CD 34 expression.P-gp positive rate in ALL was 32.1%.The P-gp expression correlate with chemotherapeutic effect in My +ALL.Conclusion My +ALL cells seemed to be resistant to conventional chemotherapy regimens;a combinative treatment protocol for both ALL and AML should improve the curative effects.The overexpression of P-gp might be responsible for the relatively low level of CR rate in My +ALL patients.更多还原