恶性肿瘤继发恶性血液病类型分析

Analysis of the subtype of hematologic malignancies secondary to malignant tumor

目的分析恶性肿瘤继发恶性血液病的常见类型及其特点。方法回顾性分析43例恶性肿瘤患者继发的恶性血液病类型。抗体标记用荧光素FIFC,PE,Per CP,APC四色方案,采用FACS-CantoⅡ流式细胞技术分析。结果 43例原发肿瘤包括以肺癌、胃癌、结直肠癌、泌尿系统肿瘤、食管癌等为主13种,常见继发的恶性血液病包括淋巴瘤(32例)和髓系白血病(11例)。淋巴瘤中NHL-T占56.25%(18/32),NHL-B占43.75%(14/32)。NHL-T的两种类型中TCR-αβ10例(10/18,55.56%),TCR-γδ8例(8/18,44.44%)。NHL-B以CLL为主。髓系白血病包括AML和CML。结论该研究分析了原发肿瘤治疗后继发的恶性血液病类型,发现T细胞淋巴瘤最为常见,其中TCR-γδ型所占比例明显升高。提示恶性肿瘤治疗过程中可能继发恶性血液病,并具有不同于一般人群发病分布的特点,有助于临床及时发现和及时治疗。

ObjectiveTo analyze the common subtypes and characteristics of hematologic malignancies secondary to malignant tumors.MethodsA retrospective study of 43 patients with hematologic malignancies secondary to malignant tumors was conducted. The immunophenotypes of the hematologic malignancies were analysed by FACS CantoⅡ flow cytometer with four color staining panel. The antibodies directly labeled with four-color of fluorescein FIFC, PE, PerCP and APC were used. Results The 43 cases with 13 types of primary tumors including lung cancer, gastric cancer, colorectal cancer, urinary system tumor and esophageal cancer were included. The most frequently observed hematologic malignancies secondary to malignant tumor were lymphoma (32 cases) and myeloid leukemia (11 cases). It was characteristically found that T cell lymphoma (NHL-T) were mostly frequently seen, accounted for 56.25% (18/32), whereas B cell lymphoma (NHL-B) for 43.75% (14/32). The two types of NHL-T were also observed, including 10 cases of TCR-αβ (10/18,55.56%) and 8 cases of TCR-γδ (8/18, 44.44%). CLL was the most frequently seen subtype among the NHL-B. The myeloid leukemia including AML and CML were also observed. Conclusion The primary malignant tumors were traditionally treated with surgery, radiotherapy and chemotherapy, which may also lead to secondary tumors. In this study the secondary hematologic malignancies after treatment to primary malignant tumors were investigated. It was found that the incidence of the subtypes of secondary hematologic malignancies were characteristically different from that of primary hematologic malignancies, in which the T cell lymphomas were most frequently observed than that of B cell lymphoma. It was also typically seen that the subtype of TCR-γδ were commonly present in secondary T cell lymphoma than that of primary T cell lymphoma. It was suggested that the secondary hematologic malignancies may occur during the treatment of malignant tumors, which require clinical attention for early detection and treatment to secondary hematologic malignancies to improve the quality for cancer patients.