医学N系白血病免疫表型特征.docVIP

NK系白血病免疫表型特征 作者：麻柔，许勇钢，杨晓红，胡晓梅，李柳，唐旭东， 张姗姗，徐述，王洪志，刘锋 【摘要】 本研究目的是探讨NK细胞系白血病的的免疫表型。应用流式细胞术检测了297例急性白血病，并就发现的6例NK细胞系白血病病例分析其免疫表型特点。结果表明： 297例急性白血病中CD56阳性43例，占14.5%，CD56阳性率21.4%-98.8%。43例中6例为 NK细胞系白血病，其余37均为急性髓系白血病伴CD56表达；6例NK细胞系白血病中1例急性前髓系/NK细胞白血病(myeloid/NK cell precursor acute leukemia)；1例伴有早幼粒细胞样形态的急性髓系/NK 细胞白血病；2例原始NK细胞白血病(blastic NK cell leukemia)，1例NK样T细胞淋巴瘤/白血病(NK-like T-cell lymphoma/leukemia)；1例大颗粒淋巴细胞白血病。结论：伴CD56阳性急性白血病，绝大部分是急性髓系白血病伴CD56表达。NK细胞系白血病免疫表型各异，表现从多能造血干细胞经历髓系抗原阳性的T/NK双向祖细胞，分化为NK系祖细胞，再进一步分化为成熟NK细胞。对不同发育阶段的抗原表达特点，应仔细辨别。 【关键词】 NK白血病 　　Immunophenotypic Features in Leukemia of NK Cell Series 　　Abstract The aim was to investigate the immunophenotypes of NK series leukemia. Immunophenotypes of 297 cases of acute leukemia (AL) were measured by flow cytometry，and these immucopenotypic features were analyzed. The results showed that 43 out of 297 cases of AL （14.5%） were CD56 positive.6 cases were NK series leukemia and 37 cases were acute myelogenous leukemia with CD56 expressed. One patient has been diagnosed as myeloid/NK cell precursor acute leukemia，two patients were blastic NK cell leukemia，one was supposed to be NK-like T-cell lymphoma/leukemia，while another one was large granular lymphocyte leukemia (LGLL). It is concluded that almost all of CD56 positive leukemia were acute myelogenous leukemia with CD56 expressed. The immunophenotypes of NK series leukemia were antigens from hematopoietic stem cells to T/NK progenitor cells with meyloid antigen positive，and through NK progenitors to mature NK cells. The immunophenotypes of heterogeneous NK leukemia cells are different，that should be carefully distinguished. 　　Key words NK leukemia；CD56；flow cytometry 　　从多能造血干细胞分化为成熟NK细胞的途径仍不明确，因此NK细胞系白血病的分析比较困难［1］。对NK细胞来源的恶性血液病最近10年有了较多的报道，它们包括急性前髓系/NK 细胞白血病(myeloid/NK cell precursor acute leukemia)、 伴有早幼粒细胞样形态的急性髓系/NK 细胞白血病(myeloid/NK cell acute leukemia)、原始NK 细胞淋巴瘤/白血病(blastic NK cell lymphoma/leukemia)。这些分型尚未在WHO和新修订的欧美淋巴瘤（REAL）分型中体现。为了进一步认识这些新的白血病类型，仅就我们在临床中