Objective: To analyze the immunological phenotype of chronic myeloid leukemia (CML), and explore its characteristics and significance.
Methods: The immunophenotypes of 40 CML children and 40 controls were analyzed by multicolor flow cytometry. CD45/SSC, as the basic gate, was used to delineate neutrophils. Then, the distribution of cluster differentiation (CD) molecules on the surface of granulocytes was analyzed in three ranges (≥1%, ≥5%, and ≥20%), and the expression rates of CD molecules (≥1% included in the statistical analysis) and the mean fluorescence intensity (MFI) were compared between the two groups.
Results: The proportion of granulocytes in the CML group was (82.1±6.4)%, which was significantly higher than (57.8±11.8)% in the control group (P <0.001). The expression rates of CD15/CD11b/CD33/CD13 in CML and control groups were high, and both distributed in the range of ≥20%. The differentiation trajectory of CD33/CD13 was normal and there were no significant differences in the expression rate and MFI between the two groups. However, both the expression rate of CD11b and CD15 MFI in the CML group were significantly lower than those in the control group (P <0.001). There were no significant differences in the expression rate and MFI of CD10 between the two groups, and the expression levels of CD10 between the two groups were consistent in different distributions. In the CML group, there was a large number of cases with abnormal high expression of CD56, 52.5% of the cases had a CD56 expression rate of ≥5%, and 42.5% had a CD56 expression rate of ≥20%, while the control group did not express CD56 (<1%). The expression distribution of CD117 was different between the two groups. In the range of expression rate ≥5%, there were 35.0% cases in the CML group, while only 2.5% in the control group. The expression rate of CD117 in the CML group was higher than that in the control group (P <0.001), though there was no significant difference in MFI.
Conclusion: The immunophenotyping of CML is characterized by increased proportion of mature neutrophils, decreased CD15 MFI, decreased proportion of CD11b and abnormal high expression of CD56 and CD117. Flow cytometric analysis of immunophenotype can effectively distinguish normal granulocytes from chronic granulocytes, and help in the diagnosis of CML.
题目: 流式细胞术在诊断慢性粒细胞白血病中的作用.
目的: 分析慢性粒细胞白血病（CML）免疫学表型，探讨其特点和意义。.
方法: 用多色流式细胞术分析40例CML患儿和40例对照骨髓免疫表型，CD45/SSC基础设门圈出中性粒细胞，分析粒细胞表面CD分子表达率在≥1%、≥5%、≥20% 3个范围的分布情况，并统计比较两组CD分子的表达率（≥1%的纳入统计）和平均荧光强度（MFI） 差异。.
结果: CML组的粒细胞比例为（82.1±6.4）%，显著高于对照组的（57.8±11.8）%（P <0.001）。CML组和对照组粒细胞CD15/CD11b/CD33/CD13表达率较高，均分布在≥20%的范围，CD33/CD13分化轨迹正常且表达率和MFI无显著差异，但CML组CD11b表达率以及CD15 MFI都显著低于对照组（P <0.001）。两组CD10表达率和MFI无显著差异且表达水平在不同范围分布情况一致。CML组CD56异常表达病例数多，表达率高，有52.5%的病例CD56表达率≥5%，42.5%的病例CD56表达率≥20%，而对照组不表达CD56（<1%）。两组CD117的表达率分布不同，在表达率≥5%区间，CML组有35.0%的病例，而对照组只有2.5%。CML组CD117表达率高于对照组（P <0.001），而MFI无显著差异。.
结论: CML的免疫分型表现为成熟的中性粒细胞比例升高、CD15 MFI减弱、CD11b比例减少、CD117表达增高以及可伴异常CD56表达，用流式细胞术分析免疫表型可以有效区分正常粒细胞和慢性粒细胞，有助于慢性粒细胞白血病辅助诊断。.
Keywords: children; chronic myeloid leukemia; flow cytometry; immunophenotype.