中文摘要：

目的研究成人急性淋巴细胞白血病（ALL）生物学特征，分析WHO2008年ALL分类的变化。方法应用流式细胞术、R显带常规核型分析法、RT—PCR技术对初诊成人ALL患者进行免疫学、细胞遗传学、分子生物学检测。结果①共412例初诊成人ALL患者，男性239例，女性173例。免疫表型可分析病例410例，B系357例，T系53例。B系的髓系抗原表达比例高于T系。髓系抗原表达与CD34表达相关。②Ph^＋和（或）ber—abl^＋ALL（简称Ph^＋ALL）患者93例，主要见于CD10^＋ALL，患者WBC、髓系抗原表达及CD34阳性率高于Ph—ALL患者。ALL伴MLL重排（MLL^＋）患者12例，主要见于早期前B—ALL。③据WHO2008年分类标准，可分析病例299例，其中B—ALL伴重现性细胞遗传学异常126例，包括B—ALL伴t（9；22）（q34；q11．2）或her—abl阳性92例，MLL^＋ALL10例，超二倍体11例，亚二倍体9例，E2A—PBX^＋ALL3例，TEL—AML1^＋ALL1例。各组间CD34及髓系抗原表达差异有统计学意义。B—ALL非特指型120例。将Ph^＋ALL、MLL^＋ALL、亚二倍体及E2A—PBX^＋ALL患者作为一组，与其他患者相比，前者年龄、WBC、HGB、外周血幼稚细胞比例、乳酸脱氢酶水平均较高。结论需结合免疫表型、细胞遗传学、分子生物学分析结果以明确ALL诊断。ALL的WHO2008年分类根据细胞遗传学对B—ALL作了更详细分类。

英文摘要：

Objective To investigate the biologic features of adult acute lymphoblastic leukemia （ALL） , and reclassified our ALL patients according to the 2008 WHO classification. Methods Immunophenotype and cytogenetic/molecular genetic results were obtained by flow cytometry, R-banding and RT-PCR, respectively. Results （1） A total of 412 newly diagnosed and previously untreated adult ALL patients, were 239 males and 173 females. Among 410 patients with available immunophenotypic results, 357 were B-ALL and 53 T-ALL. Myeloid antigen （MyAg） was higher expression in B-ALL than in T-ALL, and was correlated with the expression of CD34. （2）93 Ph ＋ ALL patients, mainly CDIO ＋ ALL, was associated with high WBC count and MyAg and CD34 expression. MLL rearrangement was found in 12 cases , mainly pro-B ALL . （3）299 cases could be analysed, according to the 2008 WHO classification of ALL, including 126 B-ALL with recurrent genetic abnormalities, and 120 B-ALL not otherwise specified. Among the 126 B-ALL with recurrent genetic abnormalities, 92 were Ph ^＋ ALL, 10 MLL ＋ ALL, 11 hyperdiploid, 9 hypodiploid, 3 E2A-PBX ＋ , and 1 TEL-AML1 ＋. Patients with Ph ＋ , MLL ＋ , hypodiploid or E2A-PBX ＋ were associated with older age, higher WBC count, higher HGB, higher peripheral blasts and higher LDH level as compared with other patients. Conclusion Combination of immunophenotype and cytogenetic-molecular profiles can provide a further detailed classification of B-ALL.