造血和淋巴组织肿瘤 实习课件.ppt

Acute lymphocytic leukemia,ALL 有核细胞增生极度活跃或明显活跃。 以原始和幼稚淋巴细胞为主，30%(NEC)，可高达50~90%，伴有形态异常。成熟淋巴细胞较少见。(NEC，non-erythroid count,即非红细胞计数，指除去幼红细胞、淋巴细胞、浆细胞、肥大细胞、巨噬细胞外的有核细胞百分比) 粒细胞系统增生受抑制，粒细胞减少，甚至少见。 红细胞系统增生也受抑制，幼红细胞少见或不见。 巨核细胞系多数显著减少或不见，血小板减少。 退化细胞明显增多，蓝细胞（涂抹细胞）多见，这是急淋的特征之一。 前驱淋巴细胞肿瘤 8． 成熟B 细胞肿瘤 9． 成熟T 细胞和NK 细胞肿瘤 10． 霍奇金淋巴瘤 11． 组织细胞和树突细胞肿瘤 12． 移植后淋巴增殖性疾病(PTLD) * * * * 分化群(cluster of differentiation, CD) ：一类分化抗原的总称，进行流水编号，至2009年已至少有350种CD分子。 大多数白细胞分化抗原在生物进化中具有保守性，但是有些小鼠白细胞分化抗原和人类还是有所不同： 某些人CD分子尚未在小鼠中确定； 某些人和小鼠CD 分子编号相同，但功能有所差别。 * Lin为谱系标记Lineage marker，是造血细胞来源的各种血细胞和免疫细胞特异性标记的总称。 Lin虽然包括很多种抗体，干细胞鉴定时，可能把它们标上同一种荧光素，只需分配一个流式通道。各流式抗体公司一般都有用于流式的lineage cocktail。 * 总T、总B和NK细胞的比例以及Th/Tc可以用来判断某些免疫缺陷和自身免疫性疾病。 * * * 非红系百分比(non erythroid cell,NEC): 去除有核红细胞、淋巴细胞、浆细胞、肥大细胞、巨噬细胞外的有核细胞百分比 * Immunophenotyping is the use of monoclonal antibodyies to identify the surface, cytoplasmic, and nuclear antigens in individual cells, thus constructing a phenotype of these cells based on positive and negative reactions to a group of antibodies Low expression or absence of HLA-DR,CD34 ,leukocyte integrins CD11a, CD11b and CD18, A homogenous, bright expression of CD33 And heterogenous express of CD13 Many cases show expression of CD117, although sometimes weak. The granulocytic differentiation markers CD15 and CD65 are negative or only weakly expressed and CD64 expression is common. In cases with microgranular morphology or bcr3 transcript of the PML-RARA fusion gene there is frequent expression of CD34 and CD2, at least on a fraction of cells. Approximately 20% of APL cases express CD56, which has been associated with a worse outcome * Compared with other types of AML, APL displays certain distinct immunophenotypic features. These include characteristic heterogeneity of high side scatter and a triad of absent or weak CD34, absent HLA-DR, and consistent CD117 expression. Other features described in the literature include homogenous, bright expression of CD33, heterogenous express of CD13, Low exp