淋巴瘤细胞白血病骨髓细胞形态学和免疫分型的特点及其在诊断中的价值

Characteristics and Diagnostic Values of Bone Marrow Cell Morphology and Immunophenotyping in Lymphoma Cell Leukemia

目的:探讨淋巴瘤细胞白血病骨髓细胞形态学和免疫分型的特点以及两者在疾病诊断中的价值。方法:回顾性分析本院2012年1月至2017年1月收治的35名淋巴瘤细胞白血病患者的骨髓涂片及骨髓免疫分型资料,观察淋巴瘤细胞白血病患者的骨髓形态和免疫分型特点及两者在淋巴瘤细胞白血病中的诊断价值。结果:所有患者骨髓中均有典型的淋巴瘤细胞的形态,免疫分型中分化抗原表达与原疾病病理类型相吻合,T细胞淋巴瘤细胞白血病患者细胞主要表达CD7、CD3、CD2、CD5、CD11b、CD34及HLA-DR,其中CD7最为敏感,其阳性率为69.2%。B细胞淋巴瘤白血病患者细胞主要表达CD19、CD20、CD22、CD79a、skappa及早期抗原HLA-DR等,其中CD19阳性率最高为89.5%。35例患者中28例骨髓涂片中淋巴瘤细胞比例与骨髓免疫分型中淋巴瘤细胞比例吻合,7例骨髓涂片的淋巴瘤细胞比例与免疫分型中淋巴瘤细胞比例相差1.5倍以上。结论:淋巴瘤细胞白血病骨髓涂片结合免疫分型在判断淋巴瘤细胞是否骨髓侵犯方面可以相互补充、取长补短,减少漏诊率,有利于淋巴瘤白血病患者的早期诊断。

Objective： To explore the characteristics and diagnostic values of bone marrow cell morphology and immunophenotyping in lymphoma cell leukemia patients. Methods ： Data of the bone marrow cell morphology and immu- nophenotyping of 35 patients with lymphoma cell leukemia admitted from January 2012 to January 2017 were analyzed retrospectively, and the value of bone marrow cell morphology and immunophenotype in the diagnosis of lymphoma cell leukemia was evaluated. Results： Bone marrow cell morphological examination showed the typical lymphoma cells in all the patients. The expression of differentiation antigens in lymphoma cell leukemia was consistent with that of original pathological diagnosis. In T-cell lyinphoma cell leukemia, the expression of CDT, CD3, CD2, CD5, CD1 lb, CD34, and HLA - DR were present predominantly, among them the CD7 was the most sensitive antigen and its positive expres- sion rate was 69.2%. In B-cell lymphoma cell leukemia, the expression of CD19, CD20, CD22, CD79a, Skappa, and early antigen HLA - DR were observed predominantly, among them the positive expression rate of CD19 was the highest （89.5%）. Out of 35 cases, 28 cases showed that the percentage of lymphoma cells on bone marrow smears was consist- ent with that of bone marrow i mmunophenotyping, and 7 cases showed that the percentage of lymphoma cells between bone marrow smears and immunophenotyping differed by Inore than I. 5 - fold. Conclusion： Bone marrow slides com- bined with immunophenotyping may be helpful for judging lymphoma cell marrow invasion and making early diagnosis of lymphoma cell leukemia.