FCM分析淋巴细胞亚群和DNA倍体在淋巴结肿大患者中的诊断意义

Diagnostic significance of lymphocyte subsets and DNA ploidy by FCM in patients with lymphadenectasis

目的评价淋巴结细针穿刺进行淋巴细胞亚群和DNA倍体分析,在淋巴结肿大患者诊断与鉴别诊断中的应用价值。方法应用流式细胞术(FCM)对淋巴结肿大患者淋巴结细针穿刺液进行淋巴细胞亚群和DNA倍体分析,并与病理组织诊断和细胞形态学比较。结果 1淋巴结肿大97例,淋巴结炎44例,非霍奇金淋巴瘤(NHL)24例,淋巴结转移癌29例,与病理组织诊断总体符合率为95.8%。2淋巴结炎患者没有异常淋巴细胞抗原表达;NHL存在异常淋巴细胞抗原表达;淋巴结转移癌患者可见一前向散射光(FS)或侧向散射光(SS)较大的CD45阴性无血液系统来源标记的细胞群。3淋巴结炎患者均为正常细胞周期,NHL和淋巴结转移癌患者出现S期比例增加或异常细胞峰。结论淋巴结穿刺进行淋巴细胞亚群和DNA倍体分析是判断肿大淋巴结性质的有效手段,有助于淋巴结肿大特别是淋巴瘤和淋巴结转移癌的早期诊断及鉴别诊断。

Objective To evaluate the diagnosis and differential diagnosis value of lymphocyte subsets and DNA ploidy about fine- needle puncture fluid from patients with lymphadenectasis. Methods Using flow cytometry to analyze the lymphocyte subsets and DNA ploidy about fine- needle puncture fluid from lymph nodes of patients with lymphadenectasis,then compared the results above with the pathological diagnosis and cell morphology. Results Out of the 97 patients with lymphadenectasis,there were 44 cases with lymphadenitis,24 cases with non- Hodgkin＇s lymphoma（ NHL） and 29 cases with lymph node metastasis. The coincidence rate was 95. 8% with histopathologic diagnosis. The lymphocyte subsets results showed no abnormal antigen expression on lymphocyte of patients with lymphadenitis; NHL was with abnormal lymphocyte antigen expression; patients with lymph node metastasis were to be found with cell populations labeled by CD45- negative blood system without source and larger scattered light（ FS） or side scatter（ SS）. Lymphadenitis patients were with normal cell cycle,NHL and lymph node metastasis in patients were with S phase increasing or abnormal cell peak. Conclusion Lymphocyte subsets and DNA ploidy of fine- needle puncture fluid by flow cytometry are an effective means to determine the nature of the lymphadenectasis,especially for the early diagnosis and differential diagnosis of lymphoma and lymph node metastases.