骨髓穿刺及活检联合流式细胞术在检测淋巴瘤骨髓侵犯中的临床研究

Clinical research of lymphoma bone marrow involvement by bone marrow smear and bone marrow biopsy plus flow cytometry

目的探讨3种骨髓检查方法(骨髓涂片、骨髓活检、流式细胞术)对淋巴瘤骨髓侵犯的临床价值。方法对50例淋巴瘤患者的骨髓标本均进行3种检查,统计不同方法骨髓侵犯的检出率、骨髓活检的侵犯类型,并进行相关分析。结果骨髓侵犯患者均为非霍奇金淋巴瘤(NHL),其中骨髓涂片阳性19例,占NHL41.3%;骨髓活检阳性25例,占NHL 54.3%;流式细胞术阳性30例,占NHL 65.2%;三者联合阳性32例,占NHL69.5%。骨髓活检显示淋巴瘤骨髓浸润方式有间质性浸润、结节性浸润、小梁旁浸润、弥漫性浸润及窦内浸润,各型淋巴瘤可见不同浸润方式。结论骨髓涂片、骨髓活检及流式细胞术联合应用能提高淋巴瘤骨髓侵犯的检出率,骨髓活检显示不同类型淋巴瘤的骨髓浸润方式有相对特异性。

Objective To explore the clinical value of three kinds of bone marrow examination methods （bone marrow smear, bone marrow biopsy and flow cytometry） in lymphoma bone marrow involvement. Methods 50 cases of lymphoma patients were exam- ined by three methods, calculated the detection rate of different methods and infiltration pattern of bone marrow biopsy, correlation analy- sis were analyzed. Results Patients with bone marrow involvement were both non - hodgking lymphoma （ NHL）, including bone marrow smear positive 19 cases （41.3%） ,bone marrow biopsy positive 25 cases （54.3%） ,flow cytometry positive 30 cases （65.2%） ,com- bined with the three examinations positive 32 cases （69.5 % ） ;Bone marrow biopsy showed that the patterns of lymphoma of bone marrow infiltration, interstitial infiltration,nodular infiltration, next to the trabecular infiltration, diffuse infiltration and sinus infiltration, and dif- ferent lymphoma had different infiltrating pattern（Conclusion The joint application of bone marrow smear, bone marrow biopsy and flow cytometry can improve the detection rate of lymphoma bone marrow involvement, bone marrow biopsy showed different types of lymphoma has specific infiltrating pattern relatively.