FCM和细胞遗传学检查在恶性淋巴瘤诊断中的意义

Significance of Flow Cytometry and Cytogenetic Techniques in the Diagnosis of Malignant Lymphoma

目的 评价流式细胞术联合细胞遗传学检查在恶性淋巴瘤确诊中意义.方法 笔者医院2009～ 2012年29例门诊及住院疑似淋巴瘤患者淋巴组织标本,制备单个核悬浮细胞,分别行流式细胞术检测细胞表面抗原的表达和R-显带检测细胞遗传学细胞核型.结果 29例患者中8例病理诊断为反应性增生或慢性炎,通过流式细胞仪和细胞遗传学诊断恶性淋巴瘤,12例患者发现核型异常,流式细胞术细胞表面抗原的检测可区分B淋系还是T淋系,区分不同亚型有指导意义,12例患者检测到异常核型,其中4例淋巴结病理提示淋巴结炎或者增生但核型发现异常染色体改变,肯定了为恶性改变,并发现有与亚型相关的特异性核型改变t（11;14）,t（14;18）,9例患者为复杂核型,提示预后不良.结论 淋巴组织病理学检查是诊断恶性淋巴瘤的基础,结合流式细胞术以及染色体检查可以提高恶性淋巴瘤的诊断率,并对淋巴瘤亚型分型以及预后判断具有指导性意义.

Objective To evaluate the significance of flow cytometry （FCM） and cytogenetic techniques in the diagnosis of malig- nant lymphoma. Methods Twenty-nine cases of suspected lymphoma patients from our hospital outpatient and inpatient from 2009 to 2012 were selected. Lymphoid tissue samples were prepared for mononuclear cell suspension. Cell surface antigen expression were detec- ted by FCM and Karyotype analysis were conducted by R - banding techniques. Results Eight cases out of 29 cases of patients with pathological diagnosis of reactive hyperplasia or chronic inflammation were diagnosed as malignant lymphoma by flow cytometry and cytoge- netic. Twelve patients were found abnormal karyotype. B or T lymphoid expression was distinguished by flow cytometry detection of cell surface antigens, which had guiding significance to distinguish different subtypes. Twelve patients were found abnormal karyotype, inclu- ding four cases of lymph node pathology diagnosed as lymphadenitis or Lymph node hyperplasia. Abnormal chromosome karyotype change certainly conformed a malignant change, t（11;14） and t（14;18） subtype -specific karyotype found in some patients were closely related to lymphoma. Nine patients with complex karyotype indicated a poor prognosis. Conclusion Lymphoid tissue pathological examination as the basis for the diagnosis of malignant lymphoma, combined with flow cytometry and chromosome examination can improve the rate of di- agnosis of malignant lymphoma, and guiding significance for lymphoma subtype classification and prognosis.