【摘要】 目的 :探讨形态学、免疫学、细胞遗传学和分子生物学方法 (MICM )分型对APL临床实用性及意义。方法 :对 2 1例急性早幼粒细胞白血病 (APL)进行了MICM的联合检测。结果 :显示形态学分型的确诊率为 90 .5 % (19/2 1) ;免疫学分析 :提示CD3 3 、CD13 、CD9、CD3 4 有一定阳性表达。尤其是CD3 3 、CD13 阳性表达高 ;染色体异常 :在初治2 0例APL中 ,t(15 ;17)检出率为 5 0 .0 % (10 / 2 0 ) ;采用RT/PCR技术检测 :AML RARα融合基因阳性率为 75 .0 %(15 / 2 0 )。结论 :形态学是诊断APL的基础 ,免疫学有辅助作用 ,t(15 ;17)及PML RARα融合基因阳性是APL生物学本质的反应 ,也是APL的诊断、ATRA治疗的选择、疗效评价及微小残留病监测的一个快速、准确且灵敏的方法更多还原

【Abstract】 Objective:To evaluate clinical practice and significance of the morphological, immunological,and cytogenetic classification in adult acute promyelocytic leukemia(APL).Methods:Combined detection of morphology immunology cytogenetics and molecular biology were performed in 21 cases of APL. Results:It was found that morphology confined diagnosis rate was 90.5%(19/21).The immunological analysis showed some antigens expression in CD 33 CD 13 CD 9 CD 34 ,and special higher antigens expression in CD 33 CD 13 .In 20 untreated APL patients,50%(10/20)chromosome translocation t(15;17) were detected.75.0%(15/20)cases revealed PML RARα fusion gene by using a retrotranscriplase polymerase chain reaction(RT/PCR)technique.Conclusion:It is shown that morphology is a diagnostic basis while immunology may play a assistant role in APL.The detection of PML RARαfusion gene is a quick,accurate and sensitive indication in the diagnosis,the choose of ATRA treatment, evaluation of therapeutic effect and monitoring of minimal residual disease(MRD)of APL.更多还原