胃MALT淋巴瘤免疫组化及病理形态定量研究

The Immunohistochemistry and Quantitative Morphometric Study of Mucosa Associated Lymphoid Tissue (MALT) Lymphoma in Stomach

目的 :探讨胃粘膜相关淋巴组织 (MALT)诊断与分类方法。方法 :对 14例MALT淋巴瘤进行免疫组化及病理形态定量测定研究。标本采用常规石蜡切片、HE染色及ABC法免组化染色 ,并应用HPIAS 10 0 0彩色图像分析系统对肿瘤细胞核的形态进行定量测定。结果 :14例胃MALT淋巴瘤中CCL细胞性 9例 ,小无裂、大无裂、T免疫母细胞性各 1例 ,CCL合并大细胞性淋巴瘤 2例。形态定量测定结果表明胃MALT淋巴瘤与对照组间 15项形态参数均有极显著性差异 (P <0 .0 0 1)。 5型肿瘤细胞核的15项形态学参数间亦大多数具有极显著性 (P <0 .0 0 1)或显著性差异 (P <0 .0 5)。尤其是细胞核的面积、周长、等效直径、面积体积、周长体积、长径、短径、实面积 8项指标随着肿瘤分类恶性程度的增高而增大 ,反映了肿瘤恶性程度的增加。结论 :形态测定的方法能够对胃MALT淋巴瘤作出准确的诊断 ,其对于MALT淋巴瘤提供了一种新的诊断方法 ,具有重要意义。

Objective:To investigate the immunohistochemistry characters and quantitative morphometric significances for the mucosa associated lymphoid tissue (MALT) lymphoma in stomach of 14 cases.Methods:The routine paraffin slides were cut, stained with H.E, and stained immunochemically by ABC method.Then, the morphologic appearance of nuclei of lymphoma cells was measured by using the HPIAS 1000 color pathology picture analysis system.Results:of the 14 cases,9 was centrocyte (CCL)like cell lymphoma, 2 CCL with large cell lymphoma, 1 small no cleaved cell lymphoma,1 large no cleaved cell lymphoma, 1 T immunoblastic malignant lymphoma.The morphologic measurement results showed that there were significant differences ( P <0 001 4) for the 15 items of morphology parameters between the nuclei of MALT lymphoma cells and those of normal control lymphocytes in stomach. There was great significance ( P <0 001)or significance ( P <0 05)for the most of the 15 items of morphologic parameters of nuclei among the 5 types of MALT lymphoma,especially the values of area, circumference,equivalent diameter,area of volume,circumference of volume,long diameter,short diameter,practical area were increasing as the rising of the malignant degree of classification, which reflect the increasing malignancy of the tumor.Conclusions:With the quantitative morphology measurement method,we can make accurate diagnosis for MALT lymphoma.It is also practicable that with morphology measurement method to make the sub classification of MALT lymphoma.