细胞遗传学联合免疫细胞化学检查在首诊非霍奇金淋巴瘤骨髓侵犯中的应用

Evaluation of the combined examination with cytogenetic and immunocytochemistry in non-hodgkin lymphoma bone marrow involvement at initial diagnosis

目的探讨细胞遗传学和免疫细胞化学检查在非霍奇金淋巴瘤骨髓侵犯(NHL-BMI)中的诊断价值。方法骨髓标本直接涂片Wright-Gimsa染色观察其形态学改变。应用骨髓细胞短期培养法制备染色体标本,以R显带技术进行核型分析。分离骨髓单个核细胞进行免疫细胞化学染色。结果24例淋巴瘤患者,骨髓受累程度各异,淋巴瘤细胞形态多样。CD20和CD79a对B细胞来源、CD3对T细胞来源淋巴瘤有诊断价值。有染色体核型异常的病例占54%(13/24),2例骨髓轻度受累患者检出核型异常。结论综合细胞遗传学、免疫细胞化学和细胞形态学检测,有助于NHL骨髓侵润的诊断,特别是对无表浅淋巴结肿大的NHL患者可能提供诊断依据。

Objective To assess the value of cytogenetic and immanocytochemistry examination in non-Hodgkin lymphoma bone marrow involvement（NHL-BMI）at initial diagnosis. Methods Morphological changes of bone marrow smears stained with Wright- Gimsa were observed under microscope. Chromosome specimens were prepared by short-term culture of bone marrow cells and kary- otype Analyses were carried out using R-banding techniques. Unidentified and uninuclear cell isolated from bone marrow were studied by using immunocytochemical staining. Results The degree of bone marrow involvement by NHL was different. Lymphoma cell in bone marrow varied in morphology. CD20, CD79 and CD3 are valuable for the differential dianosis of B- and T-cell lymphomas. In all patients, chromosomal abnormalities were found in 13patients （54 %, 13/24 ）, abnormal karyotypes were even detected in 2 ＇NHL with minimal involvement in bone marrow. Conclusion A combinated studies of cytogenetic, immunocytochemistry and morphology may be of aid to the diagnosis of NHL-BMI, especially for the diagnosis of NHL without superficial lymphadenopathy.