【摘要】 目的探讨儿童T细胞急性淋巴细胞白血病(T-ALL)的生物学性状及临床意义。方法对初诊的23例儿童T-ALL患儿进行免疫分型、染色体、融合基因检测。结果免疫分型中T系抗原以CD3阳性率最高,其次为CD7、CD5;B系抗原以CD19阳性率最高。23例中4例伴髓系抗原表达,阳性率达17%。CD34、HLA-DR表达阳性率分别为17%、22%。cCD3和cCD79的阳性表达率为100%和96%。8例行染色体检查,其中1例为超二倍体;1例为Ph+染色体。融合基因检测:5例中2例MLL基因重排异常,1例为SIL/TAL1阳性。CD3的表达与T-ALL首次化疗完全缓解率有关。结论免疫分型分析是诊断T-ALL的重要手段,但T-ALL免疫表型存在一定的异质性。对于儿童T-ALL的治疗预后评估,应结合细胞遗传学及分子遗传学进行综合判断。更多还原

【Abstract】 Objective To investigate the biological characteristics of childhood T-lineage acute lymphoblastic leukemia(T-ALL)and their clinical significance.Methods Immunophenotyping was performed by three-color flow cytometry analysis using CD45 /SSC gating in 23 children with newly diagnosed T-ALL.Meanwhile cytogenetic analysis was performed.Results CD3+ expression of T-lineage antigens was apparently higher than CD7+ and CD5+ expression.CD19+ expression of B-lineage antigens was apparently higher than CD22+,CD10+ and CD20+ expression.Myeloid antigen was expressed in 4 cases(17%).CD34+ and HLA-DR+ were observed in 4 cases(17%)and 5 cases(22%),respectively.cCD3+ and cCD79+ were expressed in 23 cases(100%)and 22 cases(96%),respectively.The chromosome detection in 8 cases with T-ALL showed hyperdiploid or Ph+ chromosome(one case each).The fusion gene detection in 5 cases showed MLL rearrangements in two cases and positive SIL/TAL1 fusion gene in one case.CD3 expression was related with the complete remission rate.Conclusions Immunophenotyping is an important tool for diagnosis of T-ALL.However,the immunophenotype of T-ALL is heterogeneous.So,immunophenotyping along with cytogenetic and molecular genetic analysis is needed in the treatment and prognosis evaluation of T-ALL.更多还原