55例非霍奇金淋巴瘤免疫分型與骨髓血液學分析

楊麗妙，　張亞平，　楊洪樂，　邢江濤，　胡　蕊，　朱　蕓

(1.河北醫科大學第二醫院檢驗科，河北 石家莊 050000；

2.河北醫科大學第二醫院輸血科，河北，石家莊 050000；

3.河北醫科大學附屬平安醫院檢驗科，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.河北醫科大學第二醫院檢驗科，河北 石家莊 050000；

2.河北醫科大學第二醫院輸血科，河北，石家莊 050000；

3.河北醫科大學附屬平安醫院檢驗科，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用價值，通過骨髓形態學了解非霍奇金淋巴瘤患者病情進展情況，以確定臨床分期。方法用單克隆相關抗體對部分非霍奇金淋巴瘤標本做免疫組化檢測，55例淋巴瘤患者均做骨髓形態學檢查。結果免疫組化：T細胞淋巴瘤相關抗體CD3陽性率85.00%，CD45RO陽性率90.47%; B細胞淋巴瘤相關抗體CD20陽性率89.65%，CD79a陽性率88.90%。骨髓形態學：淋巴瘤骨髓侵犯9例(16.36%)，進展為淋巴瘤-白血病期的7例(12.72%)。19例患者淋巴瘤細胞<5%，對此類患者應進行動態觀察，密切觀察骨髓中的形態學變化。結論免疫組化可以確定T、B淋巴瘤類型，是對組織形態學診斷的補充，使淋巴瘤診斷更準確可靠。骨髓形態學可以確定淋巴瘤患者有無骨髓侵犯及有無進展為淋巴瘤-白血病期，以確定臨床分期。

關鍵詞：淋巴瘤；非霍奇金；免疫分型；骨髓；組化

中圖分類號：

文章編號：1673-8640(2015)02-0132-05R446.11

文獻標志碼：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.

作者簡介：楊麗妙，女，1980年生，主管技師，主要研究方向為血液細胞學及臨床檢驗學。

通訊作者：朱蕓，聯系電話：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)是血液系統惡性腫瘤，其原發部位以淋巴結多見，也可發生于皮膚、胃腸、呼吸、脾、中樞神經系統等結外部位。NHL晚期容易浸潤骨髓，在骨髓內增殖，導致淋巴瘤細胞骨髓侵犯(bone marrow involvement，BMI)或進展為淋巴瘤-白血病(lymmphoma cell leukaemia, LMCL)。骨髓涂片檢查是診斷淋巴瘤BMI、LMCL的一個重要手段[1-2]，確定骨髓有無并發BMI 和LMCL，對于NHL的分期、治療及預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細胞來源，確定淋巴瘤的病理類型，使淋巴瘤診斷更為準確。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診斷中的應用價值。