摘要
目的探讨骨髓免疫病理在淋巴瘤诊断与分期中的临床意义。方法回顾性分析吉林大学第一医院肿瘤中心血液科2015年8月至2017年12月收治的266例初诊淋巴瘤患者的临床资料.比较不同骨髓检测方法对淋巴瘤诊断与分期的结果;使用SPSS 22.0软件进行统计学分析,采用x^2检验比较不同方法检测淋巴瘤骨髓浸润的阳性率.结果266例患者中.64例(24.1%)无淋巴结病理检查结果,通过骨髓检测明确淋巴瘤的诊断;64例(24.1 %)通过骨髓免疫病理检测结果明确淋巴瘤具体分型:266例淋巴瘤患者中.121例(45.5 %)经骨髓检测确定为骨髓浸润;其中霍奇金淋巴瘤(HL )和非霍奇金淋巴瘤(NHL)骨髓浸润率分别为0(0/12 )和47.6 %( 121/254 ),NHL中B细胞型及T细胞型骨髓浸润率分别为50.0 %( 105/ 210 )和36.4 %( 16/44),经骨髓检测确定为骨髓浸润的121例患者中,经骨髓涂片、骨髓活组织检查、骨髓流式细胞术、骨髓免疫病理检测的阳性率分别为78.5 %( 95 / 121 )、87.6 %( 106/ 121 ),89.3 %( 108/121 ),96.7 %( 117/ 121 );骨髓免疫病理检测阳性率高于其他检测方法,差异均有统计学意义(x^2值分别为18.38、9.09、3.76,均P< 0.05 )。经骨髓检测确定的121例骨髓浸润患者中,纠正临床分期42例(34.7 %),其中通过骨髓免疫病理检测纠正者39例(32.2 %)结论骨髓免疫病理可用于淋巴瘤的诊断与分型,其检测淋巴瘤骨髓浸润优于骨髓涂片、骨髓活组织检查及骨髓流式细胞术,并且可用于修正临床分期.
Objective To investigate the clinical significance of bone marrow immunopathogenesis in the diagnosis and staging of lymphoma. Methods Clinical data of 266 patients with newly diagnosed lymphoma admitted to Department of Hematology in the First Hospital of Jilin University from August 2015 to December 2017 were retrospectively analyzed. The results of lymphoma diagnosis and staging in different bone marrow detection methods were compared, SPSS 22.0 software was used to make statistical analysis and X^2 test was used to compare the positive rates of lymphoma bone maiTow infiltration in different methods. Results In the 266 patients. 64 cases (24.1 %) were diagnosed with lymphoma by using bone marrow detection on the condition that no lymph node pathology was available and all the immunophenotypes of 64 cases were identified by bone maiTow iminunopathology. Bone marrow infiltration was identified in 121 patients (45.5 %), among which the rate of bone manow infiltration was 0 (0/12) in Hodgkin lymphoma (HL) and 47.6 %(121/254) in non-Hodgkin lvniphoma (NHL). The rate of bone marrow infiltration was 50.0 %(105/210) and 36.4 %(16/44) in B type and T type NHL respectively. The positive rate of bone marrow infiltration detected by bone marrow smear, bone marrow biopsy, bone marrow flow cytometry and bone marrow iminunopathology were 78.5 %(95/121), 87.6 %(106/121), 89.3 %(108/121), 96.7 %(117/121) respectively. Bone marrow immunopathology was more advantageous than any other methods, and there was a statistical difference (X^2 =18.38, 9.09, 3.76;all P < 0.05). Among 121 patients who were identified with bone marrow infiltration by bone marrow detection, the staging of 42 patients (34.7 %) were amended, including the staging of 39 amended patients (32.2 %) through bone marrow immunopathologic detection. Conclusion Bone marrow immunopathology can be used for the diagnosis and classification of lymphoma, which has an obvious advantage in detecting bone marrow infiltration of lymphoma compared with bone marrow smear, bone marrow biopsy, bone marrow flow cytometry, and it can be used to amend the clinical staging.
作者
刘明锁
王书楠
刘英敏
国巍
万鑫
王沫涵
白鸥
Liu Mingsuo;Wang Shunan;Liu Yingniin;Guo Wei;Wan Xin;Wang Mohan;Bai Ou(Department of Hematology, Cancer Center, the First Hospital of Jilin University, Changchun 130021, China;Laboratory of Bone Marrow Histopathology, Department of Hematology,the First Hospital of Jilin Unirersity, Changchun 130021, China)
出处
《白血病．淋巴瘤》
CAS
2018年第12期725-730,共6页
Journal of Leukemia & Lymphoma
关键词
淋巴瘤
骨髓
免疫病理学
Lymphoma
Bone marrow
Immunopathology
