目的 检测血细胞减少患者外周血红细胞和中性粒细胞细胞膜糖基磷脂酰肌醇（GPI）连接的补体调节蛋白衰变加速因子（CD55)和膜反应性溶血抑制物（CD59）表达情况，并探讨其临床意义。 方法 2006年7月－2011年3月，采用直接免疫荧光标记法流式细胞仪检测182例血细胞减少患者外周血CD55及CD59表达情况，其中阵发性睡眠性血红蛋白尿（PNH）9例，再生障碍性贫血（AA）-PNH综合征8例，AA 83例，骨髓增生异常综合征51例，自身免疫性溶血性贫血11例，造血功能停滞6例，缺铁性贫血7例，巨幼细胞性贫血4例，脾功能亢进3例。 结果 PNH及AA-PNH患者CD55、CD59抗原缺失率均较其他血细胞减少者明显增高。 结论 流式细胞仪检测外周血中红细胞和中性粒细胞膜CD55和CD59抗原表达缺失率是目前诊断PNH可靠和敏感的方法，也是对PNH、AA-PNH早期诊断敏感指标，并且PNH克隆检测还能为诊断疾病提供鉴别诊断依据。
Objective To investigate the value of a 4-color and 10-antibody flow cytometry immunophenotyping panel using 10 antibodies including CD45, CD38, CD19, CD56, CD20, CD5, CD10, human leukocyte antigen-DR (HLA-DR), κ antibody and λ antibody marked by four kinds of fluorescein including R-phycoerythrin (PE), fluorescein isothiocyanate (FITC), peridinin chlorophy Ⅱ protein (PerCP) and allophycocyanin (APC) in the diagnosis of multiple myeloma (MM). Methods A 4-color and 10-antibody flow cytometry immunophenotyping panel which used CD45dim/-/CD38high as gating strategy supplemented by CD19, CD56, CD20, CD10, CD5, HLA-DR, κ antibody and λ antibody was used to test the bone marrow (BM) specimens of 45 MM patients treated between December 2013 and March 2015. Then by morphological examination, we analyzed the quantitative results and characteristics of myeloma cells. Results In all the 45 MM patients, the myeloma cell detection rate was 100% by flow cytometry. The proportion range of myeloma cells in BM was between 1.17% and 72.31%, which showed a good consistency with the results of 7.5%-90.0% detected by morphological examination. The positive expression rates of antigen on myeloma cells were: 100.00% for CD38, 11.11% for CD45, 2.22% for CD19, 73.33% for CD56, 17.78% for CD20, 42.22% for HLA-DR, and 0% for CD10 and CD5. About 64.44% of the MM patients were restricted cytoplasmic λ light chain typing, and 35.56% were restricted cytoplasmic κ light chain typing. There was no obvious phenotype difference among the 3 Durie-Salmon stages of MM (P>0.05). The expression of CD56 was different among different immunoglobulin types of MM, and the types of immunoglobulin with an expression from high to low were non-secretory, IgA, IgG, and light chain (P<0.05). Conclusion The 4-color and 10-antibody flow cytometry immunophenotyping panel using 10 antibodies including CD45, CD38, CD19, CD56, CD20, CD5, CD10, HLA-DR, κ antibody and λ antibody marked by four kinds of fluorescein including PE, FITC, PerCP and APC has a good diagnostic value for MM.
Objective To investigate the association between MDM2 gene promoter SNP 309 polymorphism and leukemia susceptibility. Methods Such databases as Ovid, EBSCO, PubMed, CNKI, CBM, VIP and WanFang Data were searched to collect the case-control studies published from January 1990 to June 2012. According to the inclusion and exclusion criteria, the studies were screened, the data were extracted, and the methodological quality of the included studies was evaluated. Then meta-analysis was conducted using RevMan 5.0 and Stata 10.0 software, the pooled odds ratio (ORs) with 95% confidence interval (CI) were calculated, and the sensitivity and publication bias were evaluated at the same time. Results A total of 9 studies within 8 articles were included, which involved 1 821 cases and 5 642 controls. The results of meta-analysis showed that, the susceptibility of leukemia was increased in the G allele carriers compared with the T allele carriers (OR=1.26, 95%CI 1.08 to 1.46, P=0.003), and the leukemia risk was higher in the GG genotype populations compared with the TT genotype populations (OR=1.46, 95%CI 1.02 to 2.10, P=0.04). Among Asians with recessive models, the leukemia risk was higher in the homozygous GG genotype compared with both the heterozygous GT genotype and the homozygous TT genotype (OR=2.00, 95%CI 1.37 to 2.92, P=0.000 3). There was no obvious publication bias. Conclusion MDM2 gene promoter SNP 309 polymorphism is associated with the susceptibility of leukemia, and the G allele is likely to be the risk factor for leukemia.
目的 建立急性白血病（AL）患者八色流式免疫表型分析起始管方案。 方法 用胞膜CD3（CD3）、CD19、CD10、CD34、CD45、胞浆CD79a（cCD79a）、髓过氧化物酶（MPO)和胞浆CD3（cCD3）等8种抗体建立八色流式染色方案。膜表面抗体直接染色；膜内抗体经固定破膜，再染色后上机检测。将3个血小板减少患者骨髓标本分别进行抗体的单色染色和缺一色染色；最后对17例确诊的AL初发患者标本进行检测。 结果 用单色染色来确定染色方案中各抗体的检测电压及荧光补偿；缺一色染色中，阳性细胞群较单色染色变化均＜10%，表明方案中的各抗体相互作用小。17例AL初发患者中，6例急性B淋巴细胞白血病原始细胞均为CD34和CD19阳性，5例cCD79a阳性和4例CD10阳性；4例急性T淋巴细胞白血病患者均为cCD3阳性；6例急性髓细胞白血病均为CD34和MPO阳性；1例B+T混合表型AL患者CD34、cCD3、CD19、cCD79a及CD10均为阳性，MPO和CD3为阴性，此检测方案能够确定各类AL的细胞类型。 结论 建立了AL患者八色流式免疫表型分析起始管方案，操作简便快速，适用于临床检测。