多参数流式细胞术观察251例白血病细胞CD14表达的意义

目的　探讨 CD14在白血病细胞的表达及其在白血病诊断和鉴别诊断中的意义。方法　采用 CD45 /SSC参数设门多色流式细胞术分析 2 5 1例白血病细胞 CD14及其它白血病相关抗原的表达情况。结果　 2 5 1例中有 19例 ( 7.5 % )白血病细胞表达 CD14,95例急性髓系白血病 ( AML )中 16例 ( 16 .8% )白血病细胞表达 CD14,130例淋系白血病未见 CD14阳性的病例。 M4和 M5b CD14的阳性率 ( 9/ 14;6 / 6 )明显高于 M2 ( 1/ 30 ) ( P=0 .0 0 1;P=3.6× 10 - 6 )及 M5a( 0 / 5 ) ( P=0 .0 3;P=2 .2× 10 - 3 )。标准 CD14单抗均不与 5例 M5a细胞反应 ,而自制 CD14新克隆 2 F9单抗则全部阳性。5例 M5a中 1例 CD15和 2 9例 M2 中 13例 CD11b的阳性率明显低于 M5b( 6 / 6 ,P=0 .0 2 ;6 / 6 ,P=0 .0 2 )。在 AML 组中 ,CD14的表达与 CD117呈负相关 ( r=- 0 .2 ,n=81,P=0 .0 3) ,与 CD11b、CD15及HL A- DR呈正相关 ( r=0 .5 ,n=93,P=0 .0 0 1;r=0 .4,n=95 ,P=0 .0 0 1;r=0 .2 ,n=95 ,P=0 .0 2 )。结论　 CD14有助于淋巴系白血病、髓系白血病及其单核细胞相关性白血病的诊断与鉴别 ,其对单核细胞相关性白血病免疫分型诊断中的特异性为 96 .7% ,敏感性为 6 0 .0 %。

The CD14 expression in leukemia cells with multi-parameter flow cytometry

Objective To investigate the expression of CD14 in leukemia cells and to explore its significance in diagnosis and differential diagnosis for leukemia patients. Methods Blood samples from 251 leukemia cases were analyzed by CD45/SSC double parameters and multi-color flow cytometry to determine the CD14 and other leukocyte differentiation antigens.Results The CD14 positive rate was 7.5%(19/251) in 251 cases with leukemia, 16.8%(16/95) in 95 cases with AML (acute myeloid leukemia), none of the 130 cases with lymphocytic leukemia was positive for this antigen. The positive rate of CD14 in M 4 (9/14)) and M 5b (6/6) was significantly higher than that in M 2(1/30) (both P<0.01) and M 5a(0/5) (P<0.05;P< 0.01). None of the 5 cases of M 5a reacted with the standard CD14 McAb, but all reacted with self-made new clone CD14 McAb 2F9. The positive rate of CD15 in M 5a and M 5b was 20.0% and 100.0%, respectively (P<0.05). The positive rate of CD1 1b in M 5b (100.0%) was higher than in M 2 (44.8%,P<0.05). A significantly negative regression was found between CD14 and CD117 in AML (P<0.05). CD15, CD11 b and HLA-DR had significantly positive regression with CD14 in AML (P< 0.01). Conclusion CD14 is helpful to the diagnosis and differential diagnosis of lymphoid, myeloid and monocyte lineage involved leukemia (MLIL). CD14, CD15 and CD117 are helpful to distinguish the subtypes of M 5, and CD11b is helpful to distinguish M 2 from M 5b. Self-made McAb 2F9 is helpful to the diagnosis of M 5a and the differential diagnosis of M 2 and M 4/M 5. In addition, CD117 is helpful to the recognition of the differentiation stage of leukemic monocytes.