金秋献礼，共庆双节｜一份实用的血液肿瘤免疫表型参考图表，请收好！

点击次数：163 更新时间：2025-09-26

免疫表型（Immunophenotype）是指细胞表面、细胞内或分泌的蛋白质（主要是抗原）的表达模式。不同的细胞系列（如淋巴细胞、髓系细胞）和细胞发育的不同阶段，都会表达独特的CD抗原组合。

免疫表型检测，在临床实践中通常通过流式细胞术（Flow Cytometry）或免疫组化（Immunohistochemistry）来实现，是现代血液肿瘤诊疗中不可或缺的核心技术之一。它被誉为血液病医生的“火眼金睛"，其作用贯穿于血液肿瘤的诊断、分型、预后判断和治疗监测的全过程。

上周我们更新了一篇非淋系的WHO-HAEM5（第5版造血与淋巴组织肿瘤分类）的疾病名称中英文对照。

第5版WHO造血淋巴肿瘤疾病名称中英文对照—非淋系篇

这周我们来看一下，根据WHO-HAEM5（第5版造血与淋巴组织肿瘤分类），而制作的免疫表型的表达图谱，供血液从业者日常使用参考。

免疫表型的表达图谱

（点击图片查看高清大图）

说明

（上下滑动阅览）

Waldenstr?m macroglobulinema (ICD-O code=9761/3) is found in a significant subset of patients with lymphoplasmacytic lymphoma with BM involvement and an IgM monoclonal gammopathy of any concentration.
In Heavy Chain Diseases, intracellular Ig heavy chains are not always IgMs.
Typically IgM+, and less often IgA+ or IgG+.
IgD is positive in a minority of the cases.
IgM+/-, IgD, IgG or rarely IgA.
More frequently with Lambda than Kappa restriction.
The membrane expression of CD3 may be weak.
25% of patients coexpress CD8 with CD4, a feature almost unique to T-PLL. 15% are CD4-neg, CD8-pos.
Expression of CD94/NKG2 and KIR families of receptors can be detected in 50% or more of cases.
Uncommon variants include CD4 TCRα/β-pos cases and TCRγ/δ-pos cases. Approximately 60% of the latter express CD8, the remainder are CD4/CD8-neg.
Abnormal uniform expression of CD8 can be seen.
KIR-pos cases preferentially express activating receptor isoforms.
If TCRα/β-positive, expect dierent immunophenotype for the rest of the markers.
A CD4-pos/CD8-neg phenotype predominates in nodal cases. CD4/CD8 double positivity or double negativity is at times seen.
CD13 with heterogeneous expression.
Co-expression of CD15 and strong CD64 is characteristic of monocytic dierentiation.
CD25 is highly associated with t(9;22) B-ALL, at least in adults.
NG2 is characteristically expressed and is relatively, though not absolutely, specific.
The cortical T stage shows a double positive (CD4-pos/CD8-pos) phenotype. The medullary T stage expresses only either CD4 or CD8.
IgM+/IgD+ as for B-CLL/SLL
When t(14;18) IGH/BCL2 is present, bcl2 expression is bright
>90% of cases also express Sox-11 by IHC
MYC protein is strongly expressed due to translocation of the MYC gene to the IGH, IGK, or IGL genes.
All immunophenotypes for T-ALL/T-LBL are based on IHC and NOT flow cytometry
In AML with inv(16), CD14 and CD64 are mainly expressed by the monocytic component of this AML with myelomonocytic dierentiation, and CD16 is mainly expressed by the granulocytic component
In AML with t(15;17), CD2, CD34, and CD123 are most commonly expressed by the microgranular variant
In AML with NPM1 mutation, the immunophenotype diers between cases with prominent monocytic dierentiation and cases with prominent myeloblastic morphology (the latter often has cuplike nuclear invagination if a concurrent FLT3-ITD mutation is present)
AML with RAM phenotype, a subset of megakaryoblastic AML, expresses high-level CD56 without CD7

扫码登记即可下载资料

参考文献（上下滑动阅览）

1. WHO Classification of Tumours Editorial Board. Haematolymphoid tumours. Lyon (France): International Agency for Research on Cancer; 2024.

2. Jae ES, Harris NL, Stein H, et al. Dendritic cell neoplasms: A review of the current classification. Am J Surg Pathol.

2022;46(1):100-112.

3. Feng J, Qiu Y, Zhang Y, et al. A review of the current concepts in the diagnosis and classification of dendritic cell tumors. J Clin Pathol. 2023;76(2):109-118.

4. Zhang L-F, Zhang Y, Shui R-H, et al. MNDA expression and its value in dierential diagnosis of B-cell non-Hodgkin lymphomas: a comprehensive analysis of a large series of 1293 cases. Diagn Pathol. 2024;19:60.

5. Choi JY, Lee JH, Yang WI. Reactive lymphoid hyperplasia in the lymph nodes of patients with lymphoma. Pathol Res Pract. 2021;217:153296.

6. Fujimoto M, Kikuchi M. Kikuchi's disease: the history and the current understanding of the disease. Ann Hematol.

2019;98(3):553-560.

7. Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med. 2012;366(6):539-551.

8. Wang Q, Liu H, Liu Q, et al. The clinical features of unicentric and multicentric Castleman disease: a single-center experience. Hematol Oncol. 2021;39(3):314-321.

9. Polizzotto MN, Uldrick TS, Wang V, et al. Kaposi sarcoma–associated herpesvirus (human herpesvirus 8) and the etiology of multicentric Castleman disease. Blood. 2019;133(11):1186-1197.

10. Geyer JT, Medeiros LJ, et al. Indolent T-lymphoblastic proliferation: A diagnostic dilemma. Mod Pathol. 2015;28(4):527-535.

11. Ponniah R, Chua I, et al. The challenges of diagnosing autoimmune lymphoproliferative syndrome. J Clin Pathol. 2018;71(7):651-658.

12. Krenacs T, et al. Rosai-Dorfman disease: A comprehensive review. Leuk Lymphoma. 2020;61(7):1534-1542.