55例非霍奇金淋巴瘤免疫分型与骨髓血液学分析

Immunophenotyping and bone marrow hematology analysis in 55 cases of non-Hodgkin's lymphoma

目的了解免疫组化在非霍奇金淋巴瘤诊断中的应用价值,通过骨髓形态学了解非霍奇金淋巴瘤患者病情进展情况,以确定临床分期。方法用单克隆相关抗体对部分非霍奇金淋巴瘤标本做免疫组化检测,55例淋巴瘤患者均做骨髓形态学检查。结果免疫组化:T细胞淋巴瘤相关抗体CD3阳性率85.00%,CD45RO阳性率90.47%;B细胞淋巴瘤相关抗体CD20阳性率89.65%,CD79a阳性率88.90%。骨髓形态学:淋巴瘤骨髓侵犯9例(16.36%),进展为淋巴瘤-白血病期的7例(12.72%)。19例患者淋巴瘤细胞<5%,对此类患者应进行动态观察,密切观察骨髓中的形态学变化。结论免疫组化可以确定T、B淋巴瘤类型,是对组织形态学诊断的补充,使淋巴瘤诊断更准确可靠。骨髓形态学可以确定淋巴瘤患者有无骨髓侵犯及有无进展为淋巴瘤-白血病期,以确定临床分期。

Objective To understand the progression of non-Hodgkin＇ s lymphoma through bone marrow morphology,and to find out the application significance of immunohistochemistry in the diagnosis of non Hodgkin＇ s lymphoma in order to determine the clinical stage. Methods The monoclonal antibody to some specimens of nonHodgkin＇s lymphoma was used for immunohistochemical detection,and bone marrow morphology was performed in 55 lymphoma patients. Results By immunohistochemistry,the positive rate of T cell lymphoma associated antibody CD3 was 85. 00%,and that of CD45 RO was 90. 47%,that of B cell lymphoma associated antibody CD20 was 89. 65%,and that of CD79 a was 88. 90%. By bone marrow morphology,9 cases（ 16. 36%） had bone marrow involvement,7 cases（ 12. 72%） progressed to lymphoma-leukemia period. There were 19 patients whose lymphoma cells 〈5%,for those patients,a dynamic observation should be on,which can closely observe the morphological changes in bone marrow.Conclusions Immunohistochemistry can determine the type of T or B lymphoma,and it is a supplement to the histomorphological diagnosis of lymphoma,so that a more accurate and reliable diagnosis can be made. Bone marrow morphology can determine whether the patients＇ bone marrow is involved and whether it is already advanced in leukemia period,therefore the clinical stage of lymphoma can be identified.