55例非霍奇金淋巴瘤免疫分型与骨髓血液学分析

杨丽妙，　张亚平，　杨洪乐，　邢江涛，　胡　蕊，　朱　芸

(1.河北医科大学第二医院检验科，河北 石家庄 050000；

2.河北医科大学第二医院输血科，河北，石家庄 050000；

3.河北医科大学附属平安医院检验科，河北 石家庄 050021)

55例非霍奇金淋巴瘤免疫分型与骨髓血液学分析

杨丽妙1，张亚平2，杨洪乐1，邢江涛3，胡蕊1，朱芸1

(1.河北医科大学第二医院检验科，河北 石家庄 050000；

2.河北医科大学第二医院输血科，河北，石家庄 050000；

3.河北医科大学附属平安医院检验科，河北 石家庄 050021)

摘要：目的了解免疫组化在非霍奇金淋巴瘤诊断中的应用价值，通过骨髓形态学了解非霍奇金淋巴瘤患者病情进展情况，以确定临床分期。方法用单克隆相关抗体对部分非霍奇金淋巴瘤标本做免疫组化检测，55例淋巴瘤患者均做骨髓形态学检查。结果免疫组化：T细胞淋巴瘤相关抗体CD3阳性率85.00%，CD45RO阳性率90.47%; B细胞淋巴瘤相关抗体CD20阳性率89.65%，CD79a阳性率88.90%。骨髓形态学：淋巴瘤骨髓侵犯9例(16.36%)，进展为淋巴瘤-白血病期的7例(12.72%)。19例患者淋巴瘤细胞<5%，对此类患者应进行动态观察，密切观察骨髓中的形态学变化。结论免疫组化可以确定T、B淋巴瘤类型，是对组织形态学诊断的补充，使淋巴瘤诊断更准确可靠。骨髓形态学可以确定淋巴瘤患者有无骨髓侵犯及有无进展为淋巴瘤-白血病期，以确定临床分期。

关键词：淋巴瘤；非霍奇金；免疫分型；骨髓；组化

中图分类号：

文章编号：1673-8640(2015)02-0132-05R446.11

文献标志码：码：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.

作者简介：杨丽妙，女，1980年生，主管技师，主要研究方向为血液细胞学及临床检验学。

通讯作者：朱芸，联系电话：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)是血液系统恶性肿瘤，其原发部位以淋巴结多见，也可发生于皮肤、胃肠、呼吸、脾、中枢神经系统等结外部位。NHL晚期容易浸润骨髓，在骨髓内增殖，导致淋巴瘤细胞骨髓侵犯(bone marrow involvement，BMI)或进展为淋巴瘤-白血病(lymmphoma cell leukaemia, LMCL)。骨髓涂片检查是诊断淋巴瘤BMI、LMCL的一个重要手段[1-2]，确定骨髓有无并发BMI 和LMCL，对于NHL的分期、治疗及预后均具有重要临床意义。免疫表型可使非霍奇金淋巴瘤获得T、B细胞来源，确定淋巴瘤的病理类型，使淋巴瘤诊断更为准确。选择本院病理科确诊后的NHL 55例，观察骨髓有无BMI 和LMCL，并分析免疫表型在NHL诊断中的应用价值。