Abstract
目的 通过研究儿童急性淋巴细胞性白血病患者的白血病细胞及完全缓解后患者外周血人白细胞(HLA)Ⅰ类、Ⅱ类抗原表达情况,探讨儿童急性淋巴细胞性白血病发病机制及机体免疫状态.方法采用流式细胞术检测儿童急性淋巴细胞性白血病初发患者42例、完全缓解期患者36例、对照组34例患者HLA-B、HLA-DQ、HLA-DR抗原表达.结果 (1)初发患者组的白血病细胞表面HLA-B抗原表达明显下调,初发患者组与完全缓解患者组或对照组比较,差异有显著意义(P＜0.01).(2)初发患者组白血病细胞表面HLA-DQ、HLA-DR抗原表达明显升高,尤以HLA-DR升高更为明显,初发患者组与完全缓解组或对照组比较,差异有显著意义(P＜0.01).结论 (1)急性淋巴细胞白血病人白血病细胞表面HLA-B抗原表达下调,可能是白血病细胞逃脱机体免疫监视的主要机制之一.(2)急性淋巴细胞白血病人白血病细胞表面HLA-DQ和HLA-DR抗原表达异常升高,尤其HLA-DR升高更为明显;使白血病细胞处于去分化状态,不能刺激机体产生免疫应答,可能也是白血病细胞逃脱机体免疫监视机制之一。
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