免疫分型
免疫分型概述，可用于白血病或淋巴瘤的诊断和分型
当医生认为你出现的先兆症状可能是由于得了白血病或淋巴瘤的时候；当你已经确诊得了白血病或淋巴瘤，但是具体的亚型不清楚的时候；有时候要评估治疗的效果或者评估疾病是否复发。
抽取手臂的静脉血；有时候需要骨髓，组织活检标本或者由医生收集的体液标本。
不需要。
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有何用途？
免疫分型主要地被用来帮助诊断和分类血液细胞癌，如白血病和淋巴瘤，并且有助于指导这些疾病的治疗。当全血细胞计数和分类提示淋巴细胞和不成熟细胞增多或血小板的数量明显增多或减少时，它也可被用来作为随访的试验。
针对不同类型的白血病或淋巴瘤使用已确定的各类相应的抗体检测标本。每一种癌症都有与其诊断相配备的预定义的抗体，例如这些癌症有：急性淋巴细胞白血病，急性髓细胞白血病，多毛细胞白血病，红白血病，B细胞淋巴瘤或T细胞淋巴瘤。
一般来说，医生会给可能得了白血病或淋巴瘤的患者提供相关检查的信息。除了免疫分型外，常规项目中的白细胞计数，分类和血小板计数也要被检测。抗原或抗体的选择是基于上述检测的结果。
检测可能有时候是为了评价白血病或淋巴瘤的治疗效果并且通过观察异常细胞的存在状态来检测疾病的残留或复发。
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何时检测？
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试验结果的含义？
免疫分型鉴定的某些抗原需要专业人员来解释。一位专注于研究血液疾病和/或血液细胞癌的病理学家（血液病理学家）将根据全血细胞计数，分类，血涂片，骨髓检查情况和免疫分型还有其他检测的结果综合考虑来提供一个诊断的解释。一份实验室的报告通常包括具体的检查结果和对这些结果含义的分析。
免疫分型检测的位于细胞上的标记物将有助于辨认存在的异常细胞。免疫分析结果和病人的病史，体格检查，征兆还有所有的实验室检查结果综合考虑帮助做出诊断。
（要得到血液细胞癌诊断方面更多的信息，见美国病理家学会网站，MyBiopsy.org.）
必须谨记的是，虽然所检测的结果要与“正常”结果和与白血病和淋巴瘤相关的已知抗原进行比较，但每个人的情况将是因人而异。一个人可能具有（或缺）某种典型抗原，然而仍然能被诊断为特定类型的白血病或淋巴瘤。
异常的免疫分型谱通常表现在：急性髓细胞白血病（或急性髓性白血病），急性淋巴细胞白血病，慢性淋巴细胞或髓细胞白血病，B细胞和T细胞非霍奇金淋巴瘤，红白血病（红细胞白血病），巨成红细胞白血病（血小板）和多发性骨髓瘤。
通常表达在特定细胞类型上的标记物：
细胞
标志物
不成熟的前体细胞
HLA-DR, TdT, CD34, CD38, CD117α
B-淋巴细胞
CD19, CD20, CD22, CD79a，免疫球蛋白重链（γ，α，μ或δ）和免疫球蛋白轻链（κ或λ） CD10（前B细胞）
T-淋巴细胞
CD2,CD3,CD5,CD7,和CD4或CD8中的一个
髓系细胞（粒细胞）
MPO(髓过氧化物酶), CD11, CD13, CD15, CD16b, CD33, CD66
自然杀伤细胞（NK）
CD11b, CD16, CD56
显示特定类型的细胞分化的标记物：
细胞
标志物
巨核细胞分化；血小板
CD31, CD36, CD41, CD42, CD61
红细胞分化（红系）
CD235a
单核细胞分化
CD14, CD33, CD64, CD68
毛细胞白血病
CD11c, CD103
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还有什么我需要了解的吗？
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为了检测，选择哪种类型的标本（血液，骨髓，或组织）更好些，有理由吗？
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可以在我医生的办公室做免疫分型吗？
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检测结果能用来确定我的癌症的治疗方案？
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我里内的抗原会变化吗？
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What are some methods for immunophenotyping?
Originally, glass slides with fixed tissue sections were treated with an antibody that was specific for a type of antigen typically found on certain abnormal cells associated with a particular leukemia or lymphoma. These antibodies were often linked with a fluorescence or a peroxidase indicator that would make these abnormal cells visible when observed under a microscope. Immunohistochemistry is based upon immunologic cellular properties and has proven to be particularly valuable in evaluating tissue samples that help in establishing a diagnosis or identifying relapse.
Another technique is flow cytometry and is performed by processing a blood, bone marrow, tissue, or fluid sample by adding specific antibodies that have been tagged with fluorescent markers. These antibodies will bind to corresponding antigens on the white blood cells (WBCs), if present, and are often referred to as cell markers. The WBCs are suspended in a physiologic solution and passed through a flow cytometer. The cell suspension is forced through a fluid stream that passes multiple laser beams causing deflection or absorption of the laser light. These light changes are identified by very sensitive detectors that analyze individual cells based on various physical properties.
The flow cytometer rapidly measures characteristics about each cell, such as its size and granularity (internal cellular structures), and evaluates the type and quantity of fluorescent antigen-antibody complexes that are present. The advantage of flow cytometry over Immunohistochemistry is that thousands of cells are evaluated during the test. Based on the physical characteristics of the abnormal cells and the presence (or absence) of fluorescence, the investigator can quickly determine the type of leukemia or lymphoma that may be present.