Diagnosis and Classification of Acute Leukemia in Bone Marrow Trephine Biopsies, Utility of a Selected Panel of Minimal Immunohistochemical Markers
Diagnosis and Classification of Acute Leukemia in Bone Marrow Trephine Biopsies, Utility of a Selected Panel of Minimal Immunohistochemical Markers
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骨髓环钻活检中急性白血病的诊断和分类，精选的一组最小免疫组织化学标记物的效用
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发表时间：
2016
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通讯作者：
Tadury Madhukar Subba Rao
中科院分区：
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作者：
Priya Subashchandrabose;Lakshmikanth Ramiah Madanagopaal;Tadury Madhukar Subba Rao
背景资料：急性白血病的特征在于造血干细胞的肿瘤性增殖以及原始细胞和未成熟细胞在骨髓中的积聚。我们应用一组选择性的免疫组化标记物对骨髓环钻组织切片，观察它们在急性白血病诊断和分型中的应用。材料和方法：本研究于2008年1月1日至2012年6月30日在PSG医学科学研究所完成。免疫组化检测髓过氧化物酶（MPO）、末端脱氧核苷酸转移酶（TdT）、分化抗原3（CD 3）、分化抗原20（CD 20）的表达。结果：我院平均每年新发白血病76例。其中28.7%为急性白血病，发病高峰年龄呈双峰型，性别分布几乎相等。仅9例可单纯根据形态学分型为急性髓系白血病（AML）或急性白血病（ALL）。另10例用细胞化学分型。免疫组化板有助于分型90%的病例。我们还确定了1例AML的血统不明确。用SPSS21软件进行统计学分析，卡方检验发现免疫组化有极显著性差异（p<0.01）。结论：根据我们的研究结果，我们建议使用这个有限的面板标记物的常规评估所有急性白血病。使用免疫组化比流式细胞术更容易分型，因为后者涉及成本的缺点。
Background: Acute leukemias are characterized by neoplastic proliferation of hematopoietic stem cells and accumulation of blasts and immature cells in bone marrow. We applied a selective panel of immunohistochemical markers on bone marrow trephine tissue sections and observed their utility in diagnosis and typing of acute leukemia. Materials and Methods: The study was done at PSG Institute of Medical Sciences and Research from 1st January, 2008 to 30th June, 2012. Immunohistochemistry was done to detect the expression of Myeloperoxidase (MPO), Terminal deoxynucleotidyl transferase (TdT), Cluster of Differentiation 3 (CD3) and Cluster of Differentiation 20 (CD20). Results: On an average, 76 new cases of leukemia are diagnosed each year in our hospital. Of these 28.7% are acute leukemias, which had a bimodal peak age of occurrence with almost equal sex distribution. Only 9 cases could be typed as Acute Myeloid Leukemia (AML) or Acute Lymphoid Leukemia (ALL) purely by morphology. Another 10 cases were typed using cytochemistry. Immunohistochemical panel helped to type 90% of cases. We also identified 1 case of AML of ambiguous lineage. The data were analysed statistically using SPSS version 21 and found out that the immunohistochemistry was found to be extremely significant (p<001) by Chi-Square test. Conclusions: Based on our results, we suggest the use of this limited panel of markers for routine evaluation of all acute leukemias. It is easier to type using immunohistochemistry rather than flow cytometry, given the disadvantage of the costs involved with the latter.