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目的 探讨流式细胞免疫分型在抗原异常表达淋巴瘤诊断及鉴别诊断中的作用。方法 应用流式细胞术对伴有抗原异常表达的淋巴瘤 3例 ,B淋巴细胞性白血病 8例 ,T淋巴细胞性白血病 1例及伴有淋巴细胞分化抗原表达的急性非淋巴细胞白血病 17例 ,急性粒细胞白血病累及淋巴结1例的免疫表型进行回顾性分析 ,每例均作胞质CD3ε、CD79a、髓过氧化物酶 (MPO)的EnVision两步法染色。结果 11例B细胞淋巴瘤 /白血病胞质CD79a阳性 ,胞质CD3ε及MPO阴性 ,其中 5例伴CD5表达 ,2例同时伴CD5及 1～ 2项髓系分化抗原表达 ;1例T淋巴细胞白血病胞质CD3ε阳性 ,胞质CD79a及MPO阴性 ,伴CD13、CD33表达 ;18例急性非淋巴细胞白血病 (包括 1例急性粒细胞白血病累及淋巴结 )胞质髓过氧化物酶 (MPO)均阳性 ,胞质CD3ε及CD79a均阴性 ,其中 8例 (包括 1例急性粒细胞白血病累及淋巴结 )伴T细胞分化抗原表达 ,8例伴B细胞分化抗原表达 ,2例同时伴T细胞及B细胞分化抗原表达。结论 流式细胞免疫分型不仅能发现淋巴瘤 /白血病抗原异常的表达 ,而且可通过表面免疫标记及胞质CD3ε、CD79a、MPO的表达来确定抗原异常表达淋巴瘤 /白血病的细胞来源 ,对抗原异常表达淋巴瘤 /白血病的诊断及鉴别诊断具有十分重要价值。
Objective To investigate the role of flow cytometry in the differential diagnosis of antigen-independent lymphoma. Methods Three cases of lymphoma with abnormal expression of antigen, 8 cases of B lymphocytic leukemia, 1 case of T lymphocytic leukemia and 17 cases of acute non-lymphocytic leukemia with lymphocyte differentiation antigen were analyzed by flow cytometry. Immunophenotypes of 1 patient with acute myeloid leukemia involving the lymph nodes were retrospectively analyzed. EnVision two-step staining of cytoplasmic CD3ε, CD79a and myeloperoxidase (MPO) was performed in each case. Results Eleven patients with B-cell lymphoma / leukemia were positive for cytoplasmic CD79a, negative for cytoplasmic CD3ε and MPO, 5 were associated with CD5 expression, 2 were associated with CD5 and 1-2 myeloid differentiation antigens, and 1 was T-cell lymphoblastic leukemia Cytoplasmic CD3εpositive, cytoplasmic CD79a and MPO negative, with CD13, CD33 expression; 18 cases of acute non-lymphocytic leukemia (including 1 cases of acute myeloid leukemia involving lymph nodes) cytoplasmic myeloperoxidase (MPO) were positive cells CD3ε and CD79a were negative in all cases. 8 cases (including 1 case of acute myeloid leukemia involving lymph nodes) had T cell differentiation antigen expression, 8 cases had B cell differentiation antigen expression, 2 cases had both T cell and B cell differentiation antigen expression. Conclusion Flow cytometric immunophenotyping can not only find abnormal expression of lymphoma / leukemia antigen, but also can identify the source of lymphoma / leukemia by immunohistochemistry and expression of cytoplasmic CD3ε, CD79a and MPO, Abnormal expression of lymphoma / leukemia diagnosis and differential diagnosis of great value.