55例非霍奇金淋巴瘤免疫分型與骨髓血液學(xué)分析

楊麗妙，　張亞平，　楊洪樂，　邢江濤，　胡　蕊，　朱　蕓

(1.河北醫(yī)科大學(xué)第二醫(yī)院檢驗(yàn)科，河北 石家莊 050000；

2.河北醫(yī)科大學(xué)第二醫(yī)院輸血科，河北，石家莊 050000；

3.河北醫(yī)科大學(xué)附屬平安醫(yī)院檢驗(yàn)科，河北 石家莊 050021)

55例非霍奇金淋巴瘤免疫分型與骨髓血液學(xué)分析

楊麗妙1，張亞平2，楊洪樂1，邢江濤3，胡蕊1，朱蕓1

(1.河北醫(yī)科大學(xué)第二醫(yī)院檢驗(yàn)科，河北 石家莊 050000；

2.河北醫(yī)科大學(xué)第二醫(yī)院輸血科，河北，石家莊 050000；

3.河北醫(yī)科大學(xué)附屬平安醫(yī)院檢驗(yàn)科，河北 石家莊 050021)

摘要：目的了解免疫組化在非霍奇金淋巴瘤診斷中的應(yīng)用價(jià)值，通過骨髓形態(tài)學(xué)了解非霍奇金淋巴瘤患者病情進(jìn)展情況，以確定臨床分期。方法用單克隆相關(guān)抗體對(duì)部分非霍奇金淋巴瘤標(biāo)本做免疫組化檢測(cè)，55例淋巴瘤患者均做骨髓形態(tài)學(xué)檢查。結(jié)果免疫組化：T細(xì)胞淋巴瘤相關(guān)抗體CD3陽(yáng)性率85.00%，CD45RO陽(yáng)性率90.47%; B細(xì)胞淋巴瘤相關(guān)抗體CD20陽(yáng)性率89.65%，CD79a陽(yáng)性率88.90%。骨髓形態(tài)學(xué)：淋巴瘤骨髓侵犯9例(16.36%)，進(jìn)展為淋巴瘤-白血病期的7例(12.72%)。19例患者淋巴瘤細(xì)胞<5%，對(duì)此類患者應(yīng)進(jìn)行動(dòng)態(tài)觀察，密切觀察骨髓中的形態(tài)學(xué)變化。結(jié)論免疫組化可以確定T、B淋巴瘤類型，是對(duì)組織形態(tài)學(xué)診斷的補(bǔ)充，使淋巴瘤診斷更準(zhǔn)確可靠。骨髓形態(tài)學(xué)可以確定淋巴瘤患者有無骨髓侵犯及有無進(jìn)展為淋巴瘤-白血病期，以確定臨床分期。

關(guān)鍵詞：淋巴瘤；非霍奇金；免疫分型；骨髓；組化

中圖分類號(hào)：

文章編號(hào)：1673-8640(2015)02-0132-05R446.11

文獻(xiàn)標(biāo)志碼：碼：A

DOI：10.3969/j.issn.1673-8640.2015.02.007

Abstract:ObjectiveTo understand the progression of non-Hodgkin′s lymphoma through bone marrow morphology, and to find out the application significance of immunohistochemistry in the diagnosis of non Hodgkin′s lymphoma in order to determine the clinical stage. MethodsThe monoclonal antibody to some specimens of non-Hodgkin′s lymphoma was used for immunohistochemical detection, and bone marrow morphology was performed in 55 lymphoma patients. ResultsBy immunohistochemistry, the positive rate of T cell lymphoma associated antibody CD3 was 85.00%, and that of CD45RO was 90.47%, that of B cell lymphoma associated antibody CD20 was 89.65%, and that of CD79a was 88.90%. By bone marrow morphology, 9 cases (16.36%) had bone marrow involvement, 7 cases (12.72%) progressed to lymphoma-leukemia period. There were 19 patients whose lymphoma cells <5%, for those patients, a dynamic observation should be on, which can closely observe the morphological changes in bone marrow. ConclusionsImmunohistochemistry can determine the type of T or B lymphoma, and it is a supplement to the histomorphological diagnosis of lymphoma, so that a more accurate and reliable diagnosis can be made. Bone marrow morphology can determine whether the patients′ bone marrow is involved and whether it is already advanced in leukemia period, therefore the clinical stage of lymphoma can be identified.

作者簡(jiǎn)介：楊麗妙，女，1980年生，主管技師，主要研究方向?yàn)檠杭?xì)胞學(xué)及臨床檢驗(yàn)學(xué)。

通訊作者：朱蕓，聯(lián)系電話：0311-66002765。

Immunophenotyping and bone marrow hematology analysis in 55 cases of non-Hodgkin′s lymphomaYANGLimiao1，ZHANGYaping2，YANGHongle1，XINGJiangtao3,HURui1,ZHUYun1.(1.DepartmentofClinicalLaboratory，theSecondHospitalofHebeiMedicalUniversity，HebeiShijiazhuang050000，China; 2.BloodTransfusionDepartment,theSecondHospitalofHebeiMedicalUniversity，HebeiShijiazhuang050000，China; 3.DepartmentofClinicalLaboratory，thePeaceHospitalofHebeiMedicalUniversity，HebeiShijiazhuang050021，China)

Key words: Lymphoma; Non-Hodgkin; Immunophenotyping; Bone marrow; Histochemistry

非霍奇金淋巴瘤(non-Hodkin′s lymphoma, NHL)是血液系統(tǒng)惡性腫瘤，其原發(fā)部位以淋巴結(jié)多見，也可發(fā)生于皮膚、胃腸、呼吸、脾、中樞神經(jīng)系統(tǒng)等結(jié)外部位。NHL晚期容易浸潤(rùn)骨髓，在骨髓內(nèi)增殖，導(dǎo)致淋巴瘤細(xì)胞骨髓侵犯(bone marrow involvement，BMI)或進(jìn)展為淋巴瘤-白血病(lymmphoma cell leukaemia, LMCL)。骨髓涂片檢查是診斷淋巴瘤BMI、LMCL的一個(gè)重要手段[1-2]，確定骨髓有無并發(fā)BMI 和LMCL，對(duì)于NHL的分期、治療及預(yù)后均具有重要臨床意義。免疫表型可使非霍奇金淋巴瘤獲得T、B細(xì)胞來源，確定淋巴瘤的病理類型，使淋巴瘤診斷更為準(zhǔn)確。選擇本院病理科確診后的NHL 55例，觀察骨髓有無BMI 和LMCL，并分析免疫表型在NHL診斷中的應(yīng)用價(jià)值。