| [Objective]Diagnostic classification of leukemia has experienced a series of stages, which focuses mainly on two aspects: one is the origin of the cells; the other is associated with prognosis. Leukemia is usually classified into two groups: acute chronic myelocytic leukemia and acute \ chronic lymphocyte leukemia. Besides this, there is some rare or special type leukemia. In recent 30 years, FAB classification proposed by French, American and English scholars in 1976 is a most famous one .In 1985, these scholars combined morphology, immunology and cytogenesis to propose MIC classification. MIC also absorbed much from monoclonal antibody techniques and cytogenesis .It considers not only the origin of the cells but prognosis of the disease. MIC classification plays an important role in the diagnosis of leukemia, especially in the fast diagnosis, therapy and prognosis of acute lymphocyte leukemia (ALL). According to clinical requires, our laboratory did some research about MIC in diagnosis of ALL. This article is to analyze data from laboratory detections of 200 ALL patients diagnosed on MIC standards and study the relationship among M,I,andC.[Methods]Cases are from 200 ALL patients of our hospital. Results of morphology, cytochemistry and immunology are analyzed quantitively and qualitively on the standard of FAB classification. Monoclonal antibodies are detected by FCM toanalyze immunology. [Results]1.Morphology:ALL patients' cell morphology in both marrow and peripheral blood shows that lymphoblasts and prolymphocytes increase in number, appear different in size and shape with some distinctive changes and structures.according to mophological features,ALL is classified as :1 ALL-L1 , 45 cases (small lymphoblasts >50%); 2. ALL-L2, 150 cases(big lymphoblasts >50% ) , 3.ALL-L3, 4 cases (big alveolate lymphoblasts with vacuolus in plasma dominate) ,4 macro- granules ALL (big lymphoblasts with gross azurophil granules in plasma dominated 25%).Type 4 has not been reported in literature.2.Cytochemistry:marrow cytochemical staining shows: POX(-) 100% according to FAB classification posstive reaction of leukemica cells <3% means negative(-). CE (-)100%, NSE 9.6% , inhibited by NaF. Low sensibility to cytochemistry is one feature of ALL patients.3.1mmunolagy: According to immunophenotype of the 100 cases of adult ALL 86 (86%)cases are B-ALL, 14(14%) cases are T-ALL. Classified as the william standard, the 86 cases of B-ALL including 9 cases of B-ALL-II, 55 cases of B-ALL-III, 22 cases of B-ALL-IV; the cases of T-ALL including 2 cases of T-ALL- 1, 9 cases of T-ALL- II and 3 cases of T-ALL-III. According to immunology, ALL is classified as T-ALL, ( 14%) and B-ALL, (86%). T-ALL includes T-B double phenotypic ALL (7.14%) and In T-ALL ,T with medulla expressed ALL(42.86%); In B-ALLJB with medulla expressed ALL occupies (29.07%).The analysis of sensitivity and specifity to antigen shows that, In T-ALL, the antigen of CD7 is 100%, CD5 85.7%, CD3 21.43%, cCD3 92.86%. In B-ALL, the antigen of CD10, CD19 are 100%, cCD79a 91.86%, CD22 57.64%, CD20 33.72%. 30 cases not clearly diagnosed according to FAB classification are diagnosed definitely by combiny with immunophenotype.4.Cytogenetics: 86.67% of ALL patients' chromosome number changes, mainly for subdiploid; 23% of ALL patients change in chromosome structures. t(4;11)(q22;q23) appears in one cases ALL-L1, t(9;22)(q34;q11) in 6 cases, all are ALL-L2, t(8;14)(q24;q32) in 2cases, both are ALL-L3 Marrow morphology usually shows hyper-heterogeneity in ALL patients with chromosome structure changes.[Conclusions]1.Accurate rate of clear diagnosis of ALL according to FAB classification can reach 85%, and up to 95% if combined with immunology type results.Cytogenetics were examined for adult ALL cases and found no specific changes of chromosome structures. All of these suggest that combination of M, I and C can improve diagnosis rate of ALL.2.MIC can help to distinguish ALL from ANLL (Mo, M7, M5) and mixed leukemia cases.3. MIC can help t...
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