恶性淋巴瘤患者骨髓内中性粒细胞碱性磷酸酶测定的临床意义

Study on Clinical Significance of NAP in Diagnosing Malignant Lymphoma

目的探讨骨髓内中性粒细胞碱性磷酸酶(NAP)积分的测定在淋巴瘤患者诊断、临床分期及预后判断中的临床意义。方法将我院恶性淋巴瘤骨髓侵犯49例、骨髓未侵犯51例患者的新鲜骨髓片用改良钙钴法做NAP染色,将其结果进行分析并与20例正常人的NAP染色结果比较。结果恶性淋巴瘤患者在骨髓未侵犯时NAP积分>100分的出现率在正常对照组、恶性淋巴瘤骨髓未侵犯组、骨髓侵犯组分别为0、70.6%、8.2%。随着病情的进展和骨髓侵犯,其NAP积分随之明显减低,积分<20分的出现率在正常对照组、恶性淋巴瘤骨髓未侵犯组、骨髓侵犯组分别为0%、13.7%、71.4%,具有明显的统计学差异。结论随着恶性淋巴瘤的病情进展,其骨髓片NAP活性可由高到低,提示中性粒细胞碱性磷酸酶活性的降低,可直接反映恶性淋巴瘤病情的进展程度,对恶性淋巴瘤临床分期及预后的判断具有一定的参考价值。

Objective To explore the clinical significance of neutrophilic alkaline phosphatase （NAP） in diagnosing, clinical staging and prognosis of malignant lymphoma. Methods Fresh bone marrow smears obtained from 100 cases of malignant lymphoma, including 49 cases with bone marrow involvement （BMI） and 51 eases without BMI （NBMI）, were examined by NAP staining. And the results were compared with those of 20 normal cases. Results The pereentnges of subjects with NAP score higher than 100 in the control, NBMI and BMI group were 0%, 70.6% and 8.2%, respectively. With the gradual progression of lymphoma, the patients tended to have lower NAP scores, and the percentages of the subjects with NAP score lower than 20 in the control, NBMI and BMI were 0%, 13.7% and 71.4%, showing significant differences among groups. Conclusions Decreased NAP activity can directly indicate the lymphoma progression, and NAP staining results may provide insight into the clinical staging and prognosis of malignant lymphoma.