儿童急性淋巴细胞白血病伴有TEL-AML1融合基因表达免疫表型特点.docVIP

儿童急性淋巴细胞白血病伴有TEL-AML1融合基因表达免疫表型特点 　 作者：刘怡，李志刚，赵玮，李蓓，巩文玉，吴敏媛 【摘要】 　　为了探讨伴有TEL-AML1融合基因表达的儿童急性淋巴细胞白血病（ALL ）的免疫表型及其它临床特点，采用三色流式细胞术（FCM）检测免疫表型，用巢式逆转录聚合酶链反应（RT-PCR）检测TEL-AML1融合基因的表达；同时在 FAB分型基础之上进行形态学（M）、免疫学（I）、细胞遗传学（C）分型。结果显示：①儿童B系ALL中TEL-AML1+占18.5%(22/119)，主要以L2亚型为主，糖原（PAS）染色阳性率和积分值均数分别为65%和121，均高于TEL-AML1-组（Plt;0.05）；②与儿童B系ALL TEL-AML1-组相比，TEL-AML1+年龄、性别、白细胞计数、外周血中幼稚细胞数目均未见有统计学差异；③TEL/AML1+组中，普通淋巴细胞表型占95.5%(21/22)；与TEL/AML1-组比较，CD13表达率增高（59.1%，13/22），CD20表达率减低（22.7%，5/22）（Plt;0.05）；CD10及HLA-DR的平均荧光指数（MFI值）增高，分别为92.80及53.61（Plt;0.05）。结论：儿童伴TEL-AML1融合基因表达在儿童ALL中较常见，且具有特殊的免疫表型特点，该特点可作为儿童白血病微量残留病的辅助检测。 【关键词】 急性淋巴细胞白血病； TEL-AML1融合基因；免疫表型 　　Immunophenotypic Characteristics of Children with Acute Lymphoblastic Leukemia Carrying TEL-AML1 Fusion Gene 　　Abstract To investigate the immunological and other clinical characteristics in TEL/AML1+ childhood B-acute lymphoblastic leukemia (B-ALL)，immunophenotyping was performed with three-color flow cytometry，and the expression of TEL-AML1 fusion gene was detected with nested RT-PCR. Diagnosis was made according to FAB and MIC criteria. The results showed that (1) among 119 children with B-ALL，22 (18.5%) were TEL-AML1 positive and classified as L2 morphological subtype. In TEL-AML1+ group，positive rate and score of PAS，which were 65% and 121 respectively，were all higher than that of TEL-AML1-group (Plt;0.05)； (2) compared with TEL-AML1-group，no significant difference was found in age，gender，white cell count and blasts count in peripheral blood of TEL-AML1+; (3) in TEL-AML1+ group，21 out of 22 (95.5%) were common ALL，as compared with TEL-AML1-group，the positive rate of CD13 was higher (59.1%， 13/22) and the positive rate of CD20 was lower (22.7%， 5/22) than that in TEL-AML1-group，respectively (Plt;0.05)， and the mean fluorescence index of CD10 and HLA-DR significantly increased to 92.80 and 53.61，respectively (Plt;0.05). It is concluded that TEL-AML1 rearrangement is a frequent molecular abnormality in childhood ALL. Leukemic blasts