非霍奇金淋巴瘤骨髓侵犯相关血液学因素分析

Analysis of related hematologic factors of bone marrow involvement in non-Hodgkin' s lymphoma (NHL)

目的:探讨非霍奇金淋巴瘤患者发生骨髓侵犯与相关血液学因素的关系。方法:对55例初诊的非霍奇金淋巴瘤患者进行骨髓穿刺涂片细胞学检查和骨髓活体组织检查,并检测其血常规及其他外周血相关参数的情况,分析这些参数与骨髓侵犯的相关性。结果:淋巴瘤侵犯骨髓发生率为29.09%。淋巴瘤侵犯骨髓患者的血红蛋白和血小板分别为(109.67±20.90)g/L和(148.93±96.79)×109/L,均低于无骨髓侵犯的患者[(120.31±15.21)g/L和(293.38±138.91)×109/L](P<0.05);前者D-二聚体和β2-MG分别为(2671.73±2443.12)ng/ml和(5.76±3.62)mg/L,均高于后者[(1224.29±1063.10)ng/ml和(3.28±1.59)mg/L)](P<0.05)。而淋巴瘤细胞白血病患者白细胞为(11.42±9.29)×109/L,FIB和LDH分别为(5.90±2.61)g/L和(818.33±1011.36)U/L,均高于淋巴瘤侵犯骨髓患者的水平[(5.73±2.07)×109/L,(3.64±1.29)g/L,(307.64±274.08)U/L](P<0.05)。结论:初诊的非霍奇金淋巴瘤患者,外周血象的异常、高纤维蛋白原血症以及高水平的血清D-二聚体、LDH、β2-MG,与发生骨髓侵犯相关,及时诊断淋巴瘤侵犯骨髓和淋巴瘤细胞白血病,为NHL诊治及预后判断提供指导。

Objective：To investigate the relationship between the correlative hematologic factors and bone marrow involvement in non- Hodgkin＇s lylnpholna. Methods：Bone morrow aspiration and bone morrow biopsy were detected in 55 pretreatment patients with NHL. Blood routine examination and others related hematologic parameters were detected simultaneously. We analysed the correlation of these data and bone marrow involvement. Results：The incidence of bone marrow involvement was 29.09%. The hemoglobin and platelet counts of patients with bone marrow involvement were significantly decreased than those in the group of no bone marrow involvement [ （ 109.67 ± 20.90） g/L, （148.93±96.79） ×10^9/L,vs （120.31 ± 15.21）g/L,（293.38 ± 138.91） × 10^9/L,respectively,P〈0.05].There was a significant rise on levels of D - Dilner and β2 - microglobulin in the forlner [ （ 2671.73 ± 2443.12 ） ng/ ml, （5.76 ± 3.62） mg/L,vs （ 1224.29 ± 1063.10） ng/ml, （3.28 ± 1.59 ）mg/L, respectively, P 〈 0.05 ]. The white blood cell counts of the patients with lymphoma cell leukemia were （ 11.42 ± 9.29） × 10^9/L, and the levels of fibrinogen and 1 - lactate dehydrogenase in these patients were （5.90 ± 2.61 ） g/L and （818.33 ± 1011.36） U/L,all were higher than those of the patients with bone marrow involvement [ （5.73 ± 2.07） × 10^9/L, （3.64 ± 1.29 ） g/L, （307.64 ± 274.08） U/L, respectively,P 〈 0.05 ]. Conclusion： Bone marrow involvement in pretreatment patients with NHL correlated with abnormal blood picture in peripheral blood and/or high levels of fibrinogen,D - Dimer,LDH and β2 - MG. We must pay more attention to these parameters in order to make the diagnosis promptly of bone marrow involvement and lymphoma cell leukemia in patients with NHL, both of them are indicators of treatment,diagnosis and important prognosis in NHL.